Glucagon-like peptide analogues for type 2 diabetes mellitus

Glucagon-like peptide analogues (exanatide or liraglutide), in combination with metformin or sulphonylurea or both, are effective in improving glycaemic control in patients with type 2 diabetes.

Summary

A Cochrane review included 17 RCTs with a total of 6899 subjects to assess the effectiveness of glucagon-like peptide analogues (GLP-1 analogues) compared to placebo or other antihyperglycaemic agents in improving glycaemic control in type 2 DM. Most of the studies evaluated exenatide (5 studies) or liraglutide (8 studies). All studies were of relatively short duration, minimum 8 weeks, usually 26 weeks.

In comparison with placebo, all GLP-1 agonists reduced HbA1c levels by about 1%. Exenatide 2 mg once weekly and liraglutide 1.8 mg reduced it by 0.20% and 0.24% respectively more than insulin glargine. Exenatide 2 mg once weekly reduced HbA1c more than exenatide 10 μg twice daily, sitagliptin or pioglitazone. Liraglutide 1.8 mg reduced HbA1c by 0.33% more than exenatide 10 μg twice daily. Liraglutide led to similar improvements in HbA1c compared to sulphonylureas but reduced it more than sitagliptin or rosiglitazone.

Clinical comments

There is no evidence on the effect of GLP-1 analogues on cardiovascular or other complications of diabetes.

Note

Date of latest search:

Ədəbiyyat

1. Shyangdan DS, Royle P, Clar C et al. Glucagon-like peptide analogues for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011;(10):CD006423.