New Diabetes Drug Liraglutide Works

Like Byetta, Liraglutide Cuts Blood Sugar, Weight in Type 2 Diabetes

Sept. 24, 2008 - Liraglutide, a new drug in the same class as Byetta, cuts blood sugar and lowers weight in a yearlong study of people with early type 2 diabetes.

The FDA has not yet approved liraglutide, although the new findings make eventual approval seem likely. Liraglutide requires once-daily injections. Byetta requires two injections a day, although a once-weekly version is in the works.

Liraglutide and Byetta are analogs of a hormone called GLP-1, which stimulates insulin secretion and expands insulin-making beta cells in the pancreas. A related class of diabetes drugs, the DPP-4 inhibitors, blocks an enzyme that degrades GLP-1. DPP-4 inhibitors include Januvia, approved in the U.S. and Europe, and Galvus, approved in Europe but not in the U.S.

It's not clear whether liraglutide will have the same rare-but-dangerous side effect of pancreatitis seen with Byetta -- although two such cases have been reported in patients receiving liraglutide. Both drugs can cause nausea, vomiting, and diarrhea, although these side effects tend to go away after the first month of treatment.

A downside to the DPP-4 inhibitors is that because DPP-4 plays a role in immunity, patients taking these drugs appear to have an increased risk of infections.

The new study, by Baylor College of Medicine researcher Alan Garber, MD, PhD, and colleagues, did not compare liraglutide directly to Byetta or DPP inhibitors. Instead, the study compared liraglutide to Amaryl, a member of the commonly used class of drugs called sulfonylureas, which stimulate insulin secretion.

In the study, 746 patients with early type 2 diabetes received once-daily 1.2 mg or 1.8 mg doses of liraglutide by injection or once daily Amaryl by oral tablet. Patients getting liraglutide received dummy pills; those getting Amaryl received injections of a harmless, inactive placebo.

Before treatment, patients' HbA1c scores -- a measure of long-term blood-sugar control -- ranged from 7% to 11%. After 52 weeks of treatment:

HbA1c dropped 1.14% in patients receiving 1.8 mg doses of liraglutide.

HbA1c dropped 0.84% in patients receiving 1.2 mg doses of liraglutide.

HbA1c dropped 0.51% in patients receiving Amaryl.

51% of patients getting 1.8 mg doses of liraglutide reached the American Diabetes Association target HbA1c level of less than 7.0%.

43% of patients getting 1.2 mg doses of liraglutide reached the ADA target HbA1c level.

28% of patients getting Amaryl reached the ADA target HbA1c level.

Patients treated with liraglutide lost weight, while most of those treated with Amaryl gained weight. Weight loss over the first 16 weeks of the study was maintained at the one-year mark.

Patients who had nausea for more than seven days lost 7.1 pounds on the 1.2 mg dose of liraglutide, 7.5 pounds on the 1.8 mg dose of liraglutide, and 3.15 pounds on Amaryl.

Answer:

Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia).

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.

Blood sugars consistently above 180 warrant prompt medical attention.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.