Drug Improves Glycemic Control in Type 1 Diabetics on Insulin

Results of a small-scale study conducted by researchers at that University at Buffalo suggest that an injectable medication used to treat type 2 diabetes—liraglutide—may also aid patients suffering from type 1 diabetes on insulin, and help them gain control over their blood glucose levels.

These findings were presented at the Endocrine Society in Boston, where the study was recognized as one of the most outstanding recent advancements in the field of diabetes.

These findings are so substantial because if they are confirmed in a large scale study—which is now being planned by the university researchers—then this drug would be the first new treatment for type 1 diabetes since the 1920s, when insulin was discovered.

"Since the development of injectable insulin, there has been nothing definitive in terms of a significant advance in type 1 diabetes treatments," said senior author of the study Paresh Dandona, MD, PhD, University of Buffalo distinguished professor of medicine in the School of Medicine and Biomedical Sciences. "That is the tragedy of the type 1 diabetic.”

The study was a performed as a retrospective analysis of data, and was conducted at Kaleida Health's Diabetes-Endocrinology Center of Western New York, directed by Dandona.

Dandona and colleagues studied fourteen adult participants with type 1 diabetics. The participants were given liraglutide (marketed as Victoza) for periods of time ranging from one week to twenty-four weeks.

At the beginning of the study, all fourteen patients had hemoglobin A1C levels of under seven, which is generally considered by physicians to be optimal for diabetics. In the report, the participants were characterized as "well-controlled…meticulous and disciplined" concerning their capacity to manage their blood glucose levels with insulin.

Still, even though these participants are considered to be at optimal levels, Dandona reported that nearly all type 1 diabetics experience "glycemic excursions," which is a generally broad fluctuation in their blood glucose numbers.

"The addition of liraglutide to insulin therapy in these well-controlled type 1 diabetics resulted in a significant and rapid reduction in glycemic excursions and, as a consequence, a rapid reduction in the amount of insulin they needed to take," Dandona stated.

"This study shows that liraglutide can provide even well-controlled type 1 diabetics with additional benefits that help them achieve even better blood glucose levels," continued Dandona.

Further, some participants experienced a reduction in appetite and food intake, and the participants who took the drug for twenty-four weeks reported that their body weight significantly fell.

These improvements were shown to develop quite quickly—after one to two days following the commencement of treatment—but the effects were reversed just as quickly when the treatment of adding liraglutide to insulin was discontinued. This, the researchers stated, indicates that the drug was responsible for the beneficial effects which took place in the participants.

It is not understood in depth how the introduction of liraglutide could be causing these improvements. Dandona and his fellow researchers suggested that the drug may be suppressing the increase in glucagon which typically occurs in type 1 diabetics after consuming a meal.

Dandona and his colleagues are in the process of planning a much larger, multicenter study of liraglutide and type 1 diabetics.

"We will be investigating in detail the hypothesis that it is liraglutide's ability to suppress glucagon that significantly reduces the wide swings in blood glucose levels that type 1 diabetics—even those with very good glucose control—live with everyday," concluded Dandona.

This study is published online in the European Journal of Endocrinology.