Castro-Sansores CJ, Franco-Marín AC, Martínez-Díaz G

Language: Spanish
References: 21
Page: 137-144
PDF size: 483.06 Kb.

ABSTRACT

Background: In patients with type 2 diabetes mellitus the “incretin effect” is present, but greatly reduced compared to those without this disease. The liraglutide is a GLP-1 analogous, which has been shown in studies to have beneficial effects on blood glucose concentrations.
Objective: To determine the effect of liraglutide on the hyperglycemia of patients with type 2 diabetes mellitus, which were not controlled and were treated with at least two oral hypoglycemic agents.
Material and method: A pre-experimental, longitudinal, prospective, observational and analytical study was conducted in outpatient attended in a clinic of Internal Medicine of a tertiary hospital in Merida, Yucatan, Mexico. Adult patients between 20 and 70 years old were included, previously diagnosed with T2DM, with more than five years of evolution and glycosylated hemoglobin levels greater than 7% despite treatment with at least two oral hypoglycemic. Parametric variables were expressed as frequencies and percentages. The analysis of continuous variables was expressed as mean values and standard deviation. Pre and post-test variables were compared and a value of less than 0.05 was considered statistically significant.
Results. A total of 30 patients, 16 (51.6%) women and 14 (45.2%) men with a mean age of 50.4 (38-68) years were studied. The average HbA1c achieved a reduction of 1.8% in twelve weeks of treatment with liraglutide (9.7 to 7.9%), this result was statistically significant (p ‹0.0001).
Conclusion: Liraglutide demonstrated beneficial effects in the control of diabetic patients and contributed to the improvement of other factors such as overweight and hypertension, and may give way to larger studies in number of patients and longer period of time, to demonstrate the effects of liraglutide in the short, medium and long term.

REFERENCES

1. World Health Organization. Global status report on noncommunicable diseases 2010. Description of the global burden of NCDs, their risk factors and determinants. http:// www.who.int/nmh/publications/ncd_report2010/en/

2. Secretaría de Salubridad y Asistencia. Encuesta Nacional de Enfermedades Crónicas 1993. México: Secretaría de Salud, 1994.

3. Velázquez-Monroy O, Rosas Peralta M, Lara Esqueda A, Pastelín Hernández G, et al. Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: Resultados finales de la Encuesta Nacional de Salud (ENSA) 2000. Arch Cardiol Mex 2003;73:62-77.

4. Olaíz G, Rivera J, Shamah T, Rojas R, et al. Encuesta Nacional de Salud y Nutrición. Instituto Nacional de Salud Pública 2006:1-113.

5. Rivera-Dommarco J, Gutiérrez JP. Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales. Instituto Nacional de Salud Pública, 2012.

6. Drucker D. Enhancing incretin action for the treatment of type 2 diabetes. Diabetes Care 2003;26:2929-2940.

7. Creutzfeldt W. The pre-history of the incretin concept. Regul Pept 2005;128:87-91.

8. Dharmalingam M, Sriram U, Barruah M. Liraglutide: A review of its therapeutic use as a once daily GLP-1 analog for the management of type 2 diabetes mellitus. Indian J Endocrinol Metab 2011;15:9-17.

9. Peterson G, Pollom R. Liraglutide in clinical practics: dosing, safety, and efficacy. Int J Clin Pract 2010;64:35-43.

10. Ryan G, Foster K, Johnson L. Review of therapeutic uses of liraglutide. Clin Ther 2011;33:793-811.

11. Inoue K, Maeda N, Kashine S, Fujishima S, et al. Short-term effects of liraglutide on visceral fat adiposity, appetite, and food preference: a pilot study of obese Japanese patients with type 2 diabetes. Cardiovascular Diabetology 2011;10:109-117.

12. American Diabetes Association. Standards of Medical Care in Diabetes 2014. Diabetes Care 2014;37:14-80.

13. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853.

14. Kahn SE, Haffner SM, Heise MA, Herman WH, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med 2006;355:2427-2443.

15. Astrup A, Rössner S, Van Gaal L, Rissanen A, et al.; NN8022- 1807 Study Group. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet 2009;374:1606-1616.

16. Litwak L, Maffei L, Viñes G, Cintora H, et al. Liraglutida, anaìlogo de GLP-1 humano de administracioìn una vez al diìa, mejora el control gluceìmico global en sujetos con diabetes tipo 2. Anaìlisis de la cohorte en sujetos argentinos en los LEAD 1 y 5. Rev Soc Arg Diabet 2009;43:137-149.

17. Vilsboll T, Zdravkovic M, Le-Thi T, Krarup T, et al. Liraglutide, a long-acting human glucagon-like peptide-1 analog, given as monotherapy significantly improves glycemic control and lowers body weight without risk of hypoglycemia in patients with type 2 diabetes. Diabetes Care 2007;30:1608- 1610.

18. Marre M, Shaw J, Brändle M, Bebakar WMW, et al. Liraglutide, a once-daily human GLP-1 analogue, added to a sulphonylurea over 26 weeks produces greater improve ments in glycaemic and weight control compared with adding rosiglitazone or placebo in subjects with Type 2 diabetes (LEAD-1 SU). Diabetic Medicine 2009;26:268- 278.

19. Zúñiga-Guajardo S, Aldrete J, Alexanderson E, Arechavaleta M, et al. Liraglutida en el contexto actual del tratamiento de la diabetes tipo 2. Med Int Méx 2011;27:141-159.

20. Ampudia-Blasco F, Calvo C, Cos X, García J, et al. Liraglutida en el tratamiento de la diabetes tipo 2: recomendaciones para una mejor seleccioìn de los pacientes, desde una visioìn multidisciplinaria. Av Diabetol 2010:1-9.

21. Astrup A, Carraro R, Finer N, Harper A, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Inter J Obes 2011;1-11.