title: The effects of GLP-1 analogues in obese, insulin-using type 2 diabetes in relation to eating behaviour.
abstract: BACKGROUND
  Glucagon-like peptide-1 receptor agonists (GLP-1 RA) added to insulin in type 2 diabetes patients have shown to lower body weight, improve glycaemic control and reduce total daily insulin dose in short term studies, although the individual response greatly varies.
  
  
  OBJECTIVE
  To evaluate GLP-1 RA treatment on body weight, glycaemic control and total daily insulin dose in obese, insulin-using type 2 diabetes patients after 2 years follow-up in a real life setting and to explore a possible relation with eating behaviour.
  
  
  METHODS
  The Martini Hospital and the University Medical Center in Groningen in the Netherlands.
  
  
  METHODS
  Eligible patients were at least 18 years of age, were on insulin therapy and obese (BMI > 30 kg/m(2)), started GLP-1 RA treatment. At baseline eating behaviour was classified according to the validated Dutch Eating Behaviour Questionnaire. A 2 years follow-up was performed. Main outcome measures Body weight, HbA1c and total daily insulin dose.
  
  
  RESULTS
  151 Patients started with exenatide or liraglutide. 120 patients completed the 2 years follow-up. From baseline to 2 years, body weight (mean ± SD) changed from 117.9 ± 22.1 to 107.9 ± 22.9 kg (P < 0.0001), HbA1c (median, IQR) changed from 7.9 (7.2-8.9) to 7.6 (6.9-8.3) % [63 (55-74) to 60 (52-67) mmol/mol] (P < 0.0001), total daily insulin dose changed from 90 (56-150) to 60 (0-100) Units/day (P < 0.0001). Weight change differed between eating behaviour groups (P < 0.001) in which external eating behaviour (n = 17) resulted in the smallest decline (-3.1 %) and restrained (n = 41) in the greatest (-10.3 %) in comparison with emotional (n = 37, -8.5 %) and indifferent (n = 25, -9.6 %) eating behaviours.
  
  
  CONCLUSIONS
  Two year of GLP-1 RA treatment resulted in a sustained reduction of weight, HbA1c and total daily insulin dose in obese, insulin-using type 2 diabetes patients in a real life setting. Largest weight loss was achieved in patients with a predominant restraint eating pattern while a predominant external eating pattern resulted in the smallest weight reduction.
authors.affiliation: Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands.|Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Stefanie Amarens
authors.initials: SA
authors.lastname: de Boer
authors.affiliation: Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Joop Daniel
authors.initials: JD
authors.lastname: Lefrandt
authors.affiliation: Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands.|Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Japke Frida
authors.initials: JF
authors.lastname: Petersen
authors.affiliation: Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Hendrikus Hessel
authors.initials: HH
authors.lastname: Boersma
authors.affiliation: Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Douwe Johannes
authors.initials: DJ
authors.lastname: Mulder
authors.affiliation: Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands. HoogenK@mzh.nl.
authors.forename: Klaas
authors.initials: K
authors.lastname: Hoogenberg
mesh_terms: D000368:Aged; D019440:Anti-Obesity Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000077270:Exenatide; D005247:Feeding Behavior / Q000187:drug effects*; D005260:Female; D000067757:Glucagon-Like Peptide-1 Receptor / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054795:Incretins / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D000069450:Liraglutide / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009765:Obesity / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010455:Peptides / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014688:Venoms / Q000008:administration & dosage* / Q000009:adverse effects; D015431:Weight Loss / Q000187:drug effects; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D019440:Anti-Obesity Agents; D015415:Biomarkers; D001786:Blood Glucose; D000077270:Exenatide; D000067757:Glucagon-Like Peptide-1 Receptor; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D000069450:Liraglutide; D010455:Peptides; D014688:Venoms; D000097789:Glucagon-Like Peptide-1 Receptor Agonists; C000593833:GLP1R protein, human; C517652:hemoglobin A1c protein, human
keywords: Diabetes mellitus; Eating behaviour; GLP-1 receptor agonist; Insulin therapy; Weight loss