A higher body mass index attenuates the long-term HbA1c-lowering effects of liraglutide in type 2 diabetes patients treated using sulfonylurea-based therapy

Objective: To identify the attenuating factor of glycated hemoglobin (HbA1c)-lowering effects of liraglutide in type 2 diabetes (T2D) patients over the long term.

Methods: Forty-six T2D patients received liraglutide-glimepiride combination therapy. Clinical characteristics were compared between the following two subgroups: the relapse group (≥0.4 % increase in HbA1c in 48 weeks compared to 12 weeks) and non-relapse group (remaining patients). A glucagon-loading test was performed to evaluate baseline endogenous insulin secretion.

Results: In the relapse group, significantly reduced HbA1c, as observed at 12 weeks, tended to increase at 24 and 48 weeks. In the non-relapse group, reduced HbA1c was maintained for 48 weeks. Body weight was decreased at 12 weeks and then recovered at 48 weeks in both groups. Baseline BMI was significantly higher in the relapse group than in the non-relapse group. Age, HbA1c, duration of diabetes, fasting C-peptide, daily glimepiride dose and the duration of glimepiride treatment were comparable between both groups. Multiple logistic regression analysis revealed that baseline BMI was independently associated with the relapse group.

Conclusion: A higher BMI is the leading factor for attenuating long-term glycemic control by liraglutide in T2D patients undergoing sulfonylurea-based therapy.