Drug leads to significant weight loss for people with type 2 diabetes

Study author Melanie J. Davies, professor of diabetes medicine at the Leicester Research Centre, and colleagues publish their findings in JAMA.

Obesity is an ongoing global health concern. In the US, almost 35% of adults are obese, and as a result, are at increased risk of type 2 diabetes, cancer and cardiovascular problems.

According to the International Diabetes Federation, around the globe, approximately 80% of people with type 2 diabetes are overweight or obese. It is recommended that such individuals lose weight - around 5-10% - in order to improve glycemic control, as well as reduce their risk of other health conditions.

However, Prof. Davies notes that patients with type 2 diabetes often face problems when it comes to weight loss.

"Weight loss is especially challenging for individuals with type 2 diabetes, who often experience a reduced response to weight-management pharmacotherapies compared with individuals without diabetes," she explains.

But could Prof. Davies and colleagues have discovered a way to make weight loss easier for such individuals?

Daily dose of liraglutide led to much greater weight loss
For their study, the researchers enrolled 846 overweight or obese people aged 18 and older with type 2 diabetes. Participants were recruited from 126 sites spanning nine countries.

Fast facts about type 2 diabetes
Type 2 diabetes occurs when the body does not produce enough of the hormone insulin or is unable to use it effectively
Type 2 diabetes is the most common form of diabetes, accounting for around 90% of all cases
Around 1 in 3 people in the US will develop type 2 diabetes in their lifetime.
Learn more about type 2 diabetes
Subjects were randomized to receive either a 3- or 1.8-mg dose of the diabetes drug liraglutide via injection or a placebo once daily for a total of 56 weeks. Participants were monitored for a further 12 weeks after treatment ended, allowing researchers to assess the effects of treatment cessation.

In addition, all participants were required to follow a reduced-calorie diet and increase their physical activity levels for the duration of the treatment period.

The researchers found weight loss was greater for subjects treated with liraglutide. Participants treated with 3 mg of liraglutide lost an average of 14.1 Ibs (6% of their body weight), those treated with 1.8 mg of liraglutide lost and average of 11 Ibs (4.7% of their body weight), while subjects who received the placebo only lost an average of 4.8 Ibs (2% of their body weight).

Around 54.3% of subjects treated with 3 mg of liraglutide experienced a weight loss of 5% or greater, compared with 40.4% of participants treated with 1.8 mg of the drug and 21.4% who received the placebo.

A 10% or greater weight loss occurred in 25.2% of subjects treated with 3 mg of liraglutide, 15.9% treated with 1.8mg of liraglutide and 6.7% who received the placebo.

The team found gastrointestinal disorders were more common among subjects treated with the 3-mg dose of liraglutide than those who received the 1.8-mg dose or the placebo, though there were no reports of pancreatitis. In general, the researchers report that liraglutide was well tolerated.

According to Prof. Davies, these findings indicate a daily dose of liraglutide may be an effective weight-loss strategy for overweight or obese individuals with type 2 diabetes:

"This is the first study specifically designed to investigate the efficacy of liraglutide for weight management in patients with type 2 diabetes and also the first study to investigate liraglutide at the higher 3-mg dose in a population with type 2 diabetes.

The findings from this study are significant because they represent a breakthrough in weight-loss treatment, paving the way to improved glycemic control."
The researchers note, however, that further studies are required in order to assess the longer-term efficacy and safety of liraglutide for weight loss in people with type 2 diabetes.