title: Stabilization of postprandial blood glucose fluctuations by addition of glucagon like polypeptide-analog administration to intensive insulin therapy.
abstract: OBJECTIVE
  The nature of the action of concomitant liraglutide to stabilize postprandial blood glucose level (PBG) in patients on intensive insulin therapy with unstable PBG remains unclear. The aim was to identify the nature of liraglutide's actions to stabilize PBGs.
  
  
  METHODS
  The study participants consisted of 20 diabetes patients showing unstable PBGs after dinner despite undergoing intensive insulin therapy. The dose of bolus insulin was reduced by three units for each meal, and 0.9 mg/day of liraglutide was added and used in combination. We evaluated the participants' data after the first evaluation (immediately before using liraglutide in combination) and the second evaluation (16 weeks after starting concomitant therapy). PBGs after dinner were measured every day for a period of 28 days immediately before carrying out both evaluations. The mean value of the 28 sets of blood glucose data and their standard deviation (SD) values were established as PBGs after dinner, as well as the SD for each participant. The changes in the mean values of the 20 participants, as well as their SD between before and after concomitant therapy, were evaluated.
  
  
  RESULTS
  The mean value of PBGs (12.0 ± 1.0 to 10.1 ± 0.9 mmol/L) and SD values (5.1 ± 0.7-3.5 ± 0.8) after dinner both declined. A multiple regression analysis showed that the combined use of liraglutide was a significant independent variable of the SD values of PBGs after dinner.
  
  
  CONCLUSIONS
  The treatment of reducing the dose of insulin and using liraglutide in combination not only suppresses PBGs, but also stabilizes their blood glucose fluctuations.
authors.affiliation: Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital Sendai, Japan ; Institute for Excellence in Higher Education, Division of Research in Student Support, Section of Clinical Medicine, Tohoku University Sendai, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital Sendai, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nako
authors.affiliation: Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital Sendai, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Okamura
authors.affiliation: Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital Sendai, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital Sendai, Japan.
authors.forename: Sadayoshi
authors.initials: S
authors.lastname: Ito
keywords: Intensive insulin therapy; Liraglutide; Postprandial blood glucose fluctuations