Rita Hajj-boutros, Marwa R Albadri and Sami T Azar
Objective: The aim was to compare the ability of liraglutide 1.2 mg daily to improve glucose control in overweight prediabetic compared to overweight normoglycemic subjects.
Research design and Methods: We followed 100 overweight individuals (mean age, 44 ± 12 years) treated with liraglutide 1.2 mg daily over a period of 18 months. Based on their HbA1c, they were divided in two groups: prediabetes group (A) and normoglycemic group (B). All subjects were advised to decrease calorie intake by 500 kcal/day. Weight, BMI, waist circumference, blood pressure, HbA1c, lipid profile and TSH were assessed.
Results: Six of 45 individuals (13%) in group A discontinued the study during the 18 months period compared with 8 out of 55(14%) in group B (P=0.46). Subjects in group A (n=39) lost the same percentage weight as those in group B (n=47; 5.8 vs. 7.3%; P=0.26). The percentage change in BMI was similar in both groups A and B (5.8 vs. 7.7%; P=0.19). The percentage drop in waist circumference was less in group A compared to group B (5.1 vs. 8.1%; P=0.04).
The drop in HbA1c was higher in group A compared to group B (0.3 vs. 0.1%; P=0.04). The percentage of patients that regressed to normoglycemia in group A was 15% whereas the percentage of patients that progressed to prediabetes in group B was 8%. Only two subjects progressed to diabetes in group A and none in group B. There were no differences between the two groups with respect to percent changes in BP; triglycerides; total, LDL and HDL cholesterols; and TSH.
Pre-diabetic subjects with any of the metabolic syndrome components (group A1) lost more percentage weight compared to those without any of the metabolic components (group A2) (7.3 vs. 4.8%; P=0.05).
The percentage change in BMI was more in A1 compared to A2 (7.4 vs. 5.0%; P=0.03). The percentage drop in waist circumference was similar in A1 compared to A2 (7.0 vs. 6.2%; P=0.4). The drop in HbA1c was higher in A1 compared to A2 (0.4 vs. 0.08%; P=0.04).
Conclusion: The addition of liraglutide 1.2 mg daily to calorie restriction to both pre-diabetic and normoglycemic overweight subjects resulted in a significantly more beneficial glycemic control in the pre-diabetic group despite a lower reduction in waist circumference and a similar reduction in body weight. Liraglutide resulted in normalization of glycemia in 15% of these pre-diabetic subjects and in this group, the presence of any of the metabolic syndrome component results in further weight loss and a better glycemic control.
