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Med reduces swings of Type 1 diabetes

U. BUFFALO (US) — An injectable medication used to treat Type 2 diabetes appears to also help Type 1 diabetics on insulin better control blood glucose levels.

The small observational study, published online in the European Journal of Endocrinology, could have implications as the first significant treatment for the disease since insulin was discovered and made available in the 1920s.

“Since the development of injectable insulin, there has been nothing definitive in terms of a significant advance in type 1 diabetes treatments,” says Paresh Dandona, professor of medicine at the University at Buffalo. “That is the tragedy of the type 1 diabetic.

“This study shows that liraglutide can provide even well-controlled type 1 diabetics with additional benefits that help them achieve even better blood glucose levels.”

Patients on the medication, marketed as Victoza, also saw a reduction in appetite and food intake. The study reports that body weight significantly fell in patients who took the drug for 24 weeks.

At the start of the study, all 14 patients had hemoglobin A1C levels of under 7, which is considered optimal. They were characterized in the paper as “well-controlled…meticulous and disciplined” in terms of their ability to control their blood glucose levels with insulin.

Nevertheless, even well-controlled type 1 diabetics still experience “glycemic excursions,” fairly wide swings in their blood glucose numbers ranging from the hyperglycemic, from 150 milligrams per deciliter to 250 mg/dl or higher to the hypoglycemic, under 70 mg/dl.

“The addition of liraglutide to insulin therapy in these well-controlled type 1 diabetics resulted in a significant and rapid reduction in glycemic excursions and, as a consequence, a rapid reduction in the amount of insulin they needed to take,” Dandona explains.

The improvements were shown to occur rapidly, within 1-2 days of beginning treatment with liraglutide and they reversed just as rapidly when treatment was discontinued, signifying that it was the drug that was responsible for these beneficial effects.

The mechanism behind these improvements is not well-understood but Dandona suggests that liraglutide may be suppressing the post-meal increase in glucagon, the hormone that raises glucose levels, in type 1 diabetics.

The next step, Dandona says, is a much larger, multicenter study of liraglutide in type 1 diabetics.

“We will be investigating in detail the hypothesis that it is liraglutide’s ability to suppress glucagon that significantly reduces the wide swings in blood glucose levels that type 1 diabetics—even those with very good glucose control—live with everyday.”

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