Mediterranean Journal Of Pharmacy And Pharmaceutical Sciences
Glp-1ra for glycaemic control and obesity as add-on therapy for type 2 diabetes
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Diabetes mellitus (DM) is a complex and chronic illness requiring continuous medical care. Type 2 diabetes (T2D) is commonly associated with obesity, hypertension, and a tendency to develop thrombosis, and an increase risk of cardiovascular diseases (CVD). Diabesity is a term used to indicate the coexistence of obesity and DM. Diabesity increases as obesity is an emerging epidemic in modern societies, the co-incidence with DM is also rising, so a joint plan of anti-obesity and anti-hyperglycemia for the management approaches. Therefore, this study aimed to identify the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on body weight and glycemic response in obese Libyan patients with T2D at the National Diabetes Centre in Tripoli, between July 2013 and May 2022. This prospective study included obese adults with T2D who were newly prescribed GLP-1RA therapy for six months with dulaglutide once weekly or liraglutide once daily. The study included 170 diabetic patients who were started on GLP1-RA as add on therapy to their treatment, with a regular follow-up with dietitian and their physicians to adjust their glucose-lowering medications, then comparing the effect of these agents on body weight and the level of glycated hemoglobin before and after 24 weeks of treatment. Most of the patients (n = 99, 58.23%) were in the age period from 54 to 74 years old and 101 of whom were female subjects (59.4%), with a mean duration of DM equal to 8.8 ± 7.3 years. The patients were divided randomly into two groups, the first group included 110 patients who received liraglutide pens showed a significant reduction in HbA1c from 9.6% (± 1.54) to 7.4% (± 1.03) by p < 0.001 and a significant weight loss from 88.3 kg (± 10.68) to 80.8 kg (± 11.83) by p < 0.001. The reported adverse events were in 23 cases of minor hypoglycemia due to gastrointestinal upset. The other group included 60 patients for dulaglutide pens and showed significant decrease in HbA1c = 9.6% (± 1.54) to 7.1% (± 1.2) by p < 0.05 and a significant reduction of bodyweight from 88.3 kg (± 10.68) to 83.8 kg (± 16.3) by p < 0.05. The reported adverse events were mild transient gastrointestinal distress for the initial week of a start and then subside with regular intake. Whereas, 115 patients (67.6%) with HbA1c above 10.0% before starting therapy, no patient with HbA1c above 10.0% after six months of both GLP-RA agents therapy. Thus, the uses of GLP-RA as add-on therapy for obese patients with T2D significantly improved glycaemic control with less hypoglycaemia, accordingly, reduce insulin requirement for blood glucose control and loss in body weight. It can thus be concluded that GLP-1RA therapy is an effective treatment option when used in obese patients with DM.
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