New Drug Lowers Blood Sugar in Diabetic Patients on High Insulin Doses

Obese patients typically require higher doses of insulin therapy.

The new drug liraglutide was found to reduce blood sugar in diabetic patients taking high doses of insulin.

The 3 main effects liraglutide has on the body is increased insulin secretion, decreased hunger, and decreased glucagon secretion. In a study published in both the Journal of the American Medical Association-Internal Medicine and the Journal of Clinical Endocrinology & Metabolism, researchers wanted to test the efficacy of liraglutide in patients given larger doses of insulin.

“We have a growing population of obese patients who require larger and larger doses of insulin,” said researcher IIdiko Lingvay. “The insulin causes them to put on more weight, which in turn means their glucose levels remain out of control. We wanted to test whether treating such patients with liraglutide would have an effect.”

For the study, researchers enrolled 71 patients with type 2 diabetes who had hemoglobin A1C (HbA1C) levels that were 7.5 or higher and were overweight. The participants were also currently injecting large amounts of insulin daily, and in most cases 4 or 5 injections a day.

Participants were randomized to receive a daily injection of either a placebo or liraglutide, in addition to their current high insulin dose therapy. The results of the study found that the average HbA1C level of patients taking liraglutide dropped from 8.9 to 8 compared with long-term blood sugar levels, which stayed the same in the placebo arm.

Additionally, patients in the liraglutide arm lost 4.5 pounds on average, while the placebo arm gained a small amount on average.

“This is less improvement than we normally see with liraglutide in patients who are not on insulin, but this is a huge improvement in a population that is so difficult to treat,” Lingvay said.

During the study, researchers also looked at the mechanisms of action of the drug in the liraglutide group, as well as the effect of the drug on the underlying disease. Following a meal, insulin and glucagon blood levels were measured, which showed insulin production increased.

“The results were counterintuitive,” Lingvay said. “One might expect that patients with such long-standing disease would have little or no residual beta-cell function and improvements would be driven through suppression of glucagon. To the contrary, we found that liraglutide exerted its hypoglycemic effect through improving insulin secretion.”