title: Liraglutide narrows the range of circadian glycemic variations in Japanese type 2 diabetes patients and nearly flattens these variations in drug-naive type 2 diabetes patients: a continuous glucose monitoring-based study.
abstract: BACKGROUND
  Liraglutide was examined for its effects on 24-h glucose fluctuations in Japanese type 2 diabetes patients as well as for its differential effects depending on glucose tolerance status after favorable glycemic control was obtained in these patients.
  
  
  METHODS
  In this prospective open-label pilot study, a total of 20 type 2 diabetes patients hospitalized for glycemic control were given liraglutide 0.3 mg, followed by liraglutide 0.6 mg and 0.9 mg, with each given at 1-week intervals. The patients were continuously monitored for their 24-h glucose levels before treatment and during the course of treatment with liraglutide 0.3 mg, 0.6 mg, and 0.9 mg, respectively, using continuous glucose monitoring (CGM). At the start of treatment with liraglutide, 12 patients were on diet therapy alone, of which six were drug-naive, and eight were being treated with glimepiride.
  
  
  RESULTS
  Liraglutide not only significantly reduced 24-h mean glucose levels but also significantly improved all the indices for glycemic variation evaluated, which included SDs of 24-h glucose levels, mean amplitude of glycemic excursions (MAGE), and total area under the glucose fluctuation curve (AUC) for 24 h. The study showed a significant negative correlation for mean glucose levels, SD, and AUC immediately before treatment versus their changes with liraglutide. A 75-g oral glucose tolerance test (OGTT) was given in 11 patients treated with liraglutide monotherapy once favorable glycemic control was achieved. The OGTT revealed that of these, six were found to have normal glucose tolerance, four had impaired glucose tolerance, and one had diabetes, and that of the six drug-naive patients, five patients were found to have normal glucose tolerance, and one had impaired glucose tolerance.
  
  
  CONCLUSIONS
  Study results showed that liraglutide is expected not only to reduce mean glucose levels but also to improve 24-h glucose fluctuations, including postprandial glucose excursions, with its effects being particularly conspicuous in patients with early-stage type 2 diabetes.
authors: Division of Diabetes and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan. morisumikojp@yahoo.co.jp
authors: Yutaka
authors: Y
authors: Mori
authors: Yukiko
authors: Y
authors: Taniguchi
authors: Kazunori
authors: K
authors: Sezaki
authors: Junichi
authors: J
authors: Yokoyama
authors: Kazunori
authors: K
authors: Utsunomiya
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015190:Blood Glucose Self-Monitoring; D002940:Circadian Rhythm / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000188:drug therapy*; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000069450:Liraglutide; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human; C057619:glimepiride