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Real-world effectiveness of liraglutide in children with type 2 diabetes
Gabriel Castano Heredia1,2,3, Rebecca Schneider Aguirre1,2, Jennifer Bell1,2
1Division of Diabetes and Endocrinology, Texas Children's Hospital, Houston, TX 77030, USA.
Importance:
Since liraglutide's approval for the treatment of type 2 diabetes (T2D) in children, no real-world studies have examined its clinical outcomes in adolescents.
Objective:
Compare hemoglobin A1c (HbA1c) changes in adolescents with T2D taking liraglutide in a clinical setting.
Design:
Retrospective cohort study from 2020 to 2023.
Participants:
Patients with T2D ages <18 years who were prescribed liraglutide. Patients were divided into 2 groups: treated (those with evidence of taking liraglutide for ≥26 weeks) and control (those prescribed but who did not take liraglutide).
Main Outcomes:
Changes in HbA1c after 26 weeks of treatment were calculated. Secondary outcomes included HbA1c changes after 52 weeks, and body mass index (BMI) z score changes and lipid markers at 26 and/or 52 weeks.
Results:
There was a strong trend toward a decrease in HbA1c after 26 weeks of liraglutide treatment compared with control (-0.40 [-1.90, 0.20] vs +0.15 [-1.30, 0.88], P = .064; n = 85 vs n = 30); no difference was observed at 52 weeks (-0.20 [-1.23,0.93] vs 0.50 [-1.13,1.70], P = .15; n = 100 vs n = 44). BMI z score was stable in both groups, with no differences between groups. Lipid levels were available in a small subset of patients. The liraglutide-treated group had a decrease in total cholesterol (-0.21 [-0.60, 0.16] mmol/L vs 0.49 [0.06, 0.76] mmol/L, P = .005; n = 36 vs n = 12) and low-density lipoprotein (-0.23 [-0.56, 0.16] mmol/L vs 0.35 [0.14, 0.63] mmol/L, P < .01; n = 31 vs n = 12) vs control.
Conclusion:
Liraglutide shows potential benefits for lowering HbA1c and cholesterol in children with T2D in a clinical setting. Additional work is needed to understand how to optimize HbA1c improvements with liraglutide.
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