Weight Loss Drug Could Reverse Pre-Diabetes

Findings from a new study suggest that a repurposed weight loss drug could reduce the risk of diabetes in patients with pre-diabetes.

In the study published by The Lancet, the authors found that daily administration of liraglutide reduced the risk of type 2 diabetes by 80% compared with placebo among high-risk patients.

Pre-diabetes is characterized by higher than normal blood glucose levels, and can progress to type 2 diabetes when left untreated. This condition affects 1 in 10 individuals living in the UK, and up to 10% of patients develop diabetes within 10 years, the study noted.

While pre-diabetes can be cured with exercise and diet, diabetes is much more difficult to treat. Both conditions are associated with premature death and poor health outcomes, such as nerve damage, blindness, and amputation, according to the study.

The study authors found that the drug, liraglutide, can prevent disease progression when combined with exercise and a healthy diet. This treatment may even cure pre-diabetes.

Included in the study were 2254 patients with obesity and pre-diabetes. Patients were either treated with liraglutide plus diet and exercise or diet and exercise alone.

After 3 years, the investigators found that patients treated with liraglutide were 80% less likely to develop diabetes than control patients. In 60% of those patients, pre-diabetes was reversed, and patients were observed to have normal blood glucose levels, according to the study.

While a majority of patients did not develop diabetes, those treated with liraglutide took nearly 3 times longer to develop the condition, compared with placebo.

Additionally, treatment with liraglutide was associated with sustained weight loss. Patients treated with the drug lose 7% of body weight over 3 years, compared with only 2% weight loss in the placebo group.

"These groundbreaking results could pave the way for a widely used, effective, and safe drug to reverse prediabetes and prevent diabetes in 80 per cent of at-risk people,” said researcher Carel le Roux, MBChB, MSC, PhD. “This could improve the health of the population and save millions on healthcare spending."

The authors believe that the drug works by mimicking the action of the appetite suppressing hormone GLP-1, according to the study. The hormone is released in the hypothalamus when food is consumed to suppress appetite.

Previous research suggests that patients with obesity produce less GLP-1, which can lead to overeating. The new findings show that preventing overeating with liraglutide could result in the prevention of diabetes and weight gain in some patients.

In the UK, liraglutide is approved to manage weight loss and diabetes, but is expensive and not widely available. Further research could develop a GLP-1 deficiency test to determine the patients who would benefit most from the costly drug, the study noted. Patients could also undergo a short 12-week treatment period to determine the benefits of the drug, and stop taking the drug if no benefit is seen, according to the study.

"Liraglutide promotes weight loss by activating brain areas that control appetite and eating, so that people feel fuller sooner after meals and their food intake is reduced,” Dr le Roux concluded. “Although liraglutide's role in weight loss is well known, this is the first time it has been shown to essentially reverse prediabetes and prevent diabetes, albeit with the help of diet and exercise."