Liraglutide Could Raise Nighttime Heart Rate in Obese Patients with Type 1 Diabetes

Adding liraglutide to insulin treatment for type 1 diabetes has proven to lower body weight and reduce the frequency of hypoglycemia. Potential heart risks, however, have yet to be established. But results from a study that analyzed cardiovascular outcomes related to liraglutide were revealed at the American Diabetes Association (ADA 2016) 76^th Scientific Sessions in New Orleans, Louisiana.

Researchers from a Danish pharmaceutical company, Novo Nordisk A/S, focused on liraglutide’s effect on 24h ambulatory blood pressure (AmBP), 24h heart rate, arterial stiffness, and carotid intima-media thickness.

The analysis included 100 obese patients with type 1 diabetes on insulin treatment. These patients also had insufficient glycemic control. Half of the participants received liraglutide 1.8 mg once a day or placebo once a day for 24 weeks. There were similar baseline characteristics between the liraglutide and placebo groups — including average age (47 vs. 49), HbA1c (72 vs. 72 mmol/mol), body mass index (BMI) (30.3 vs. 29.8 kg/m²), and diabetes duration (20 vs. 25 years). All of the patients were Caucasian and about 65% were male.

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“After 24 weeks, nighttime heart rate and diastolic blood pressure increased by 6.5 bpm and 4.9 mmHg, respectively, in liraglutide-treated compared with placebo-treated patients,” the authors identified. However, there were no differences between the groups when it came to heart rate, daytime diastolic blood pressure, and daytime and nighttime systolic blood pressure.

A post-hoc analysis including patients with daytime systolic blood pressure above the media (136 mmHg) showed a decrease in both the liraglutide and placbo groups (6.0 vs. 10.5 mmHg). Nighttime systolic blood pressure also decreased in this population (4.7 vs. 7.0 mmHg, respectively).

The authors concluded that adding liraglutide to an insulin regimen increases nighttime heart rate and nighttime diastolic blood pressure in obese patients with type 1 diabetes and insufficient glycemic control. However, daytime and nighttime systolic blood pressure, daytime diastolic blood pressure, daytime heart rate, arterial stiffness, and carotid intima-media thickness remained unchanged.

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