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GLP-1 Agonists in Type 1 Diabetes Mellitus
Kristin M Janzen1, Taylor D Steuber2, Sarah A Nisly2
1Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA Indiana University Health, Indianapolis, IN, USA kjanzen@butler.edu.
The Annals of Pharmacotherapy
|June 3, 2016
Summary
Glucagon-like peptide 1 (GLP-1) agonists may aid weight loss in type 1 diabetes mellitus (T1DM) patients. While GLP-1 agonists showed modest A1C reduction, gastrointestinal issues like nausea are a concern.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Type 1 diabetes mellitus (T1DM) management remains challenging, with many patients struggling to achieve glycemic targets.
- Obesity is a common comorbidity in T1DM, further complicating treatment strategies.
Purpose of the Study:
- To review the efficacy and safety of glucagon-like peptide 1 (GLP-1) agonists in patients with type 1 diabetes mellitus (T1DM).
- To identify potential benefits and limitations of using GLP-1 agonists as an adjunct therapy in T1DM.
Main Methods:
- A systematic search of MEDLINE, EMBASE, and Cochrane Database was conducted up to March 2016.
- Included were English-language clinical trials investigating GLP-1 agonists for glycemic control in human T1DM patients.
Main Results:
- Nine clinical trials were identified, showing a modest average reduction in hemoglobin A1C (A1C) of 0.6% from baseline.
- GLP-1 agonists demonstrated significant weight loss (up to 6.4 kg) but were associated with gastrointestinal side effects, primarily nausea.
- Hypoglycemia rates were comparable to insulin monotherapy.
Conclusions:
- GLP-1 agonists may be considered for overweight or obese T1DM patients not meeting glycemic goals with insulin therapy alone.
- Liraglutide shows the most evidence for use in this population, but tolerability due to gastrointestinal adverse effects is a key consideration.
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