Novel, Once Weekly GLP-RA For Diabetes Reduced HbA1c and Weight in 30 Week Trial

MedicalResearch.com Interview with:

Christopher Sorli, MD SUSTAIN 1 investigator and  Chair of the Department of Diabetes, Endocrinology and Metabolism Billings Clinic, Billings, Montana

Dr. Christopher Sorli

Christopher Sorli, MD
SUSTAIN 1 investigator and
Chair of the Department of Diabetes, Endocrinology and Metabolism
Billings Clinic, Billings, Montana

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Sorli: GLP-1 receptor agonists (GLP-1 RAs) have been found to be useful in the treatment of Type 2 diabetes with potent effects on blood glucose lowering while minimizing the risk of hypoglycemia and weight gain often seen with other classes of hypoglycemic agents.

Semaglutide is a novel GLP-1RA that is currently in clinical development. The molecule shares 94% amino acid homology with native GLP-1 and has a half-life of approximately one week allowing for once weekly dosing.

SUSTAIN 1 was designed to demonstrate superiority of semaglutide 0.5 mg and 1.0 mg once weekly over placebo in lowering HbA1c after 30 weeks of treatment. Additional secondary endpoints included weight loss versus placebo, percent of patients achieving HbA1c goals, percent of patients achieving 5% and 10% weight loss, and safety and tolerability.

Continue reading

Switching from Sitagliptin to Liraglutide Can Control Hyperglyciemia in Some With Type 2 Diabetes

MedicalResearch.com Interview with:

Dr. Maximo Maislos MD Head of the Atherosclerosis and Metabolism Unit Department of Medicine of the Soroka University Medical Center Israel

Dr. Maximo Maislos

Dr. Maximo Maislos MD
Head of the Atherosclerosis and Metabolism Unit
Department of Medicine of the Soroka University Medical Center
Israel

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Maislos: When diet and exercise are insufficient, Type 2 Diabetes Mellitus patients are generally started on metformin, and when intensification is required, a drug is recommended.

The incretin family of drugs includes oral DPP-4 inhibitors and injectable glucagon-like peptide-1 receptor agonist (GLP-1RA). Both are equally recommended as a second-line therapy by the American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) position statement.

We hypothesized that by switching insufficiently controlled subjects on metformin+sitagliptin (DPP-41) to metformin+liraglutide (GLP-1 RA), more patients with type 2 diabetes would achieve better glycemic control without needing to add a third antidiabetic agent.

In our study we were able to show that subjects insufficiently controlled on sitagliptin who switch to liraglutide can obtain clinically relevant reductions in glycemia and body weight, without compromising safety. A switch from sitagliptin to liraglutide provides an option for improved management of type 2 diabetes while still allowing patients to remain on dual therapy.

MedicalResearch.com: What should clinicians and patients take away from your report? 

Dr. Maislos: It is possible to achieve better glycemic control by switching  from sitagliptin (DPP-4i) to liraglutide and maintaining the patient in a two drug therapeutic regime.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Maislos:  Treatment of diabetes mellitus should be individualized, tailored to the patient’s  specific needs.

MedicalResearch.com: Is there anything else you would like to add? 

Dr. Maislos:  Treatment of diabetes mellitus should be individualized, tailored to the patient’s  specific needs.

Citation: Abstract presented at the 2016 ENDO Meeting, April 2016

Efficacy and safety of switching from sitagliptin to liraglutide in subjects with type 2 diabetes: a randomized, double-blind, double-dummy, active-controlled 26-week trial

Timothy S Bailey1, Róbert Takács2, Francisco Tinahones Madueño3, Anne Bloch Thomsen4, Margit Staum Kaltoft4 and Maximo Maislos*5
1AMCR Institute Inc., Escondido, CA, 2University of Szeged, Szeged, Hungary, 3University of Málaga, CIBERobn, Instituto de Salud Carlos III, Málaga, Spain, 4Novo Nordisk A/S, Søborg, Denmark, 5Soroka University Medical Center, Beer Sheva, Israel

Dr. Maximo Maislos MD (2016). Switching from Sitagliptin to Liraglutide Can Control Hyperglyciemia in Some With Type 2 Diabetes MedicalResearch.com

Sleeve-IT Surgery Achieves Glycemic Control in Mildly Obese Diabetic Patients

MedicalResearch.com Interview with:
Ana Priscila Soggia
Sirio Libanes Hospital, São Paulo, Brazil

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many years, bariatric surgery is performed to treat class II and III obesity with diabetes remission in 80-90% of cases, related to weight loss and change in the secretion of intestinal factors that control blood glucose, like GLP-1 and GIP.

In 2010, the International Diabetes Federation (IDF), proposed that diabetic patients with BMI between 30-35kg/m2 could be eligible, for bariatric surgery, in the case of no glycemic control with drug treatment. In this context, once glycemic control after bariatric surgery, was not related only to weight loss and also due to intestinal factors with physiological actions, the protocol was proposed.

The objectives were to compare the clinical and surgical treatment in diabetics patients with class I obesity; and to compare the efficacy and security between two different surgical techniques.

This study was developed and conducted by a research team from Sirio-Libanês Hospital in partnership with Ministry of Health through its philanthropic program PROADI. It is a clinical trial, with 42 class I obese diabetic type 2 patients with inadequate glycemic control that were randomized to tree arms: clinical treatment, gastric bypass surgery or sleeve with ileal transposition (sleeve-IT) surgery.

The results showed that the sleeve-IT procedure is more effective for the treatment of diabetes in these patients compared with treatment with medication and with bypass surgery, currently considered the first choice of treatment. Among patients who underwent sleeve-IT, 100% achieved glycemic control after 1 year (HbA1c<6,5%) compared to 46% for bypass and 8% in the case of medication therapy. In addition, diabetes remission, that was defined as adequate glycemic control without any anti-diabetic medication, occured in 75% of sleeve-IT patients had versus 30% in bypass group.

Continue reading