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ACP Journal Club |20 December 2016

In type 1 diabetes, adding liraglutide to insulin increased hypoglycemia and hyperglycemia with ketosis

Michael Tanner, MD

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Mathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: The ADJUNCT ONE treat-to-target randomized trial. Diabetes Care. 2016;39:1702-10. 27506222

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Endocrinology:

In patients with type 1 diabetes mellitus, does adding liraglutide to treat-to-target insulin treatment improve glycemic control?
Randomized placebo-controlled trial (ADJUNCT ONE Treat-To-Target Randomized Trial). ClinicalTrial.gov NCT01836523.
Concealed.*
Blinded* (patients, clinicians, {and study coordinators}†).
1 year.
177 centers in 17 countries.
1398 patients 18 to 75 years of age (mean age 44 y, 52% women) who had type 1 diabetes for ≥ 12 months treated with basal bolus or continuous subcutaneous insulin infusion for ≥ 6 months, stable insulin treatment for the past 3 months, body mass index ≥ 20 kg/m2, and hemoglobin (Hb) A1c levels 7.0% to 10% (53 to 86 mmol/mol). Exclusion criteria included treatments that affect glycemic control, acute or chronic pancreatitis, estimated glomerular filtration rate < 30 mL/min/1.73 m2, calcitonin level > 50 ng/L at baseline, personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, or severe neuropathy.
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Tanner M. In type 1 diabetes, adding liraglutide to insulin increased hypoglycemia and hyperglycemia with ketosis. Ann Intern Med. ;165:JC64. doi: 10.7326/ACPJC-2016-165-12-064

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Published: Ann Intern Med. 2016;165(12):JC64.

DOI: 10.7326/ACPJC-2016-165-12-064

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2016 American College of Physicians
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