Glycemic variability in type 2 diabetes mellitus and acute coronary syndrome: liraglutide compared with insulin glargine: a pilot study

Autores de IIS La Fe

• María Isabel Del Olmo García

  Autor

• David Hervás Marín

  Autor

• Jana Caudet Esteban

  Autor

• Antonio Ballesteros Martín Portugués

  Autor

• Alba Cervero Rubio

  Autor

• Miguel Ángel Arnau Vives

  Autor

• Ana Isabel Catalá Gregori

  Autor

• Juan Francisco Merino Torres

  Autor

Participantes ajenos a IIS La Fe

• Martinez, MP

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

• Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética clínica

Abstract

Objective To explore the glucagon-like peptide-1 analogue liraglutide in the hospital setting in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome and to evaluate the safety and efficacy and its impact on hospitalization and short-term glycemic variability (GV). Methods A 12-week, open-label, prospective, randomized pilot clinical study with parallel groups that compared liraglutide (group 1) with glargine (group 2) and its impact on glycemic control and GV. Results Thirteen patients were included. During hospitalization, mean glucose was 164.75 mg/dL (standard deviation [SD] 19.94) in group 1 and 166.69 mg/dL (38.22) in group 2. GV determined by CV and SD was 20.98 (7.68) vs. 25.48 (7.19) and 34.37 (13.05) vs. 43.56 (19.53) in groups 1 and 2, respectively. Group 1 prandial insulin requirements during hospitalization were lower compared with group 2. Follow-up A1c in group 1 was 6.9% (-1.51%) and 6.5% in group 2 (-1.27). GV after discharge and hypoglycemia were lower in group 1 compared with group 2. Conclusions Liraglutide seems to reduce GV in the acute phase of acute coronary syndrome, and patients achieved optimal control with a low incidence of hypoglycemia. These results support the need to explore liraglutide in a larger multicenter trial.

Keywords

• Glycemic variability; type 2 diabetes mellitus; acute coronary syndrome; liraglutide; GLP-1 receptor agonist; hypoglycemia