Effective Switch From Twice-Daily Pre-Mixed Insulin 50/50 to Liraglutide to Achieve a Good Glycemic Control in Type 2 Diabetes

Abstract

     The glucagon-like peptide 1 (GLP-1) stimulates insulin secretion from pancreatic ?-cells in a glucose-dependent manner. Therapeutic strategies for type 2 diabetes mellitus are focused on the use of GLP-1 analogues. Liraglutide, an acylated analogue of human GLP-1, has been introduced in Japan in 2010. We will show a 70-year-old woman with type 2 diabetes mellitus achieving a good glycemic control by switching from twice-daily pre-mixed insulin 50/50 to liraglutide. Measurements of plasma glucose and serum C-peptide levels before and after each meal ingestion and daily urinary C-peptide levels suggested that liraglutide ameliorates glucose metabolism mainly not by the glucose-dependent insulinotropic effect but by amelioration in insulin sensitivity. Furthermore, results from a glucagon-loading test indicated that liraglutide reduced plasma glucose levels not by enhancing insulin secretion but by suppressing glucagon-mediated hepatic glucose output. 




doi:10.4021/jmc143w