Short term effects of liraglutide versus vildagliptin on insulin secretion and sensitivity in type 2 diabetes (Liravis study)
Estelle Amandine Well1,2,&, Simeon Pierre Choukem3,4, Mesmin Dehayem1, Jean-Claude Njabou Katte2, Jean Claude Mbanya1,2,5, Eugene Sobngwi1,2,5
1National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon, 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon, 3Douala General Hospital, Douala, Cameroon, 4Faculty of Health Sciences, University of Buea, Buea, Cameroon, 5Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon
Estelle Amandine Well, National Obesity Center, Yaoundé Central Hospital, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
incretinomimetics are new type 2 diabetes mellitus drugs that have the ability to increase glucose-induced insulin production. This drug class has two subclasses: Exogenous Glucagon-Like Peptide analogs (GLP1a) such as Liraglutide, and the inhibitors of Dipeptidyl peptidase IV (DPP4i) that prolong the half-life of endogenous GLP1 such as vildagliptin.We aimed to evaluate the short term metabolic effects of a GLP-1a, liraglutide versus a DPP-4i, vildagliptin on type 2 diabetes patients.
we conducted a randomized controlled single blind clinical trial on 14 uncontrolled type 2 diabetes patients (HbA1c = 53mmol/mol). Participants were randomly allocated in 2 groups. Anthropometric measurements, hyperinsulinemic-euglycemic clamp at 80mU/m2/min and a mixed meal tolerance test (to assess insulin sensitivity/secretion) were carried out before and after the different interventions. In group 1, 0.6mg/day of liraglutide was administered subcutaneously and increased to 1.2mg the 2nd week whereas, 100mg/day of oral vildagliptin was administered in group 2 for 2 weeks.
after the intervention insulin sensitivity remained unchanged: liraglutide (6.6 [4.2-7.9] to 6.9 [4.3-10.8] mg/kg/min; p=0.61) and vildagliptin (7.1 [5.3- 9.0] to 6.5 [5.6-9.4] mg/kg/min; p= 0.86). LDL Cholesterol levels decreased significantly in group 1(0.85 [0.51-1.02] to 0.54 [0.50-0.73] g/L, p=0.04) but not in group 2 (p= 0.23). Concerning insulin secretion, the area under the C-peptide curve varied from (5.5[1.0-10.9] to 14.9 [10.8-17.2] nmol/L/120min, p=0.09) in group 1 and from 1.1 [0.5-14.1] to 13.0 [9.6-16.9] nmol/L/120min, p=0.17) in group 2, showing a non-significant trend towards improvement. A variation in body weight was remarked amongst the groups, being, - 0.6kg and +1.1kg in group 1 and 2 respectively.
there are no significant differences on insulin sensitivity and insulin secretion after two weeks of treatment using liraglutide and vildagliptin, in type 2 diabetes mellitus patients.