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Possibility of switching from liraglutide to oral hypoglycemic agents as a useful therapeutic option for obese Japanese type 2 diabetics

Author(s): Masanori Iwanishi*, Choka Azuma, Yuji Tezuka, Yukako Yamamoto, Jun Ito-Kobayashi & Miki Washiyama

Objective: Our aim was to examine the influence of switching to oral hypoglycemic agents on post-switching weight loss and blood glucose control in obese Japanese patients with type 2 diabetes after long-term therapy with a glucagon-like peptide 1 (GLP-1) receptor agonist.

Methods: In 8 obese patients with type 2 diabetes, oral hypoglycemic agents were introduced after long-term therapy with a GLP-1 receptor agonist, liraglutide, based on their wishes. We investigated the oral glucose tolerance test (OGTT) and the subsequent changes in HbA1c and body weight in all patients.

Results: Concerning the patient background, the mean age was 44.4 years. The mean body mass index (BMI) was 30.0 kg/m2, and the mean duration of diabetes was 0.3 years. The mean HbA1c value before liraglutide administration was 10.3%. The mean liraglutide treatment period was 1.1 years. The mean HbA1c value on switching liraglutide to oral hypoglycemic agents was 5.7%. The mean rate of change in the body weight after liraglutide administration was -9.2 kg, and the mean BMI upon switching liraglutide to oral hypoglycemic agents was 26.8 kg/m2. The oral hypoglycemic agents consisted of DPP- 4 inhibitors in 7 patients, SGLT2 inhibitors in 3, and metformin in 1. In 4 of the 8 patients, weight gain was noted. The OGTT demonstrated that insulin secretion was maintained in the subjects.

Conclusion: Our observation suggested the possibility that the therapeutic strategy of administering liraglutide and switching to oral hypoglycemic agents after confirming maintenance of weight loss and normal HbA1c value for a specific period might be useful for treating type 2 diabetics with a relatively short duration of diabetes during the initial phase after diagnosis, This therapy may become a new treatment option, although our report included small patient numbers and this strategy warrant the need for further investigation.

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