Efficacy of liraglutide therapy in Japanese type 2 diabetic patients insufficiently controlled with basal-supported oral therapy.
(J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00223.x, 2012) Aims/Introduction:  We assessed the efficacy of liraglutide therapy in Japanese type 2 diabetic patients insufficiently controlled with basal-supported oral therapy (BOT).


METHODS
We retrospectively analyzed the data of 37 patients who had postprandial hyperglycemia (≥10.0 mmol/L) with BOT (long-acting insulin plus glimepiride) with their insulin titrated enough to keep preprandial glycemia <7.2 mmol/L, and who had their treatment changed to liraglutide monotherapy, with the subsequent addition of glimepiride, when required. Those who achieved the glycemic target at all points (preprandial glycemia <7.2 mmol/L and postprandial glycemia <10.0 mmol/L) were regarded as responders and the efficacy of liraglutide therapy was assessed. We also explored the predictive clinical characteristics associated with its efficacy.


RESULTS
Daily doses of insulin and glimepiride with BOT were 14 ± 9 units and 1.5 ± 0.9 mg, respectively. After the change to liraglutide therapy, 37% of the patients appeared to be responders to the therapy, whereas 12% had their glycemic control rather deteriorated. Efficacy of liraglutide therapy was significantly associated with baseline insulin dosage and post-breakfast glycemia with BOT. The C-statistic of the model was calculated to be 0.90.


CONCLUSIONS
There were responders and non-responders to liraglutide therapy in Japanese BOT failures. It is likely that baseline insulin dosage and post-breakfast glycemia with BOT are clinically useful indicators for the efficacy of liraglutide therapy.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Mitsuyoshi
M
Takahara
Shiraiwa Medical Clinic.
Toshihiko
T
Shiraiwa
Otoshi Medical Clinic, Osaka, Japan.
Kentaro
K
Ohtoshi
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Hideaki
H
Kaneto
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Naoto
N
Katakami
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Taka-Aki
TA
Matsuoka
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Iichiro
I
Shimomura
Basal‐supported oral therapy; Japanese; Liraglutide