In overweight or obese patients with prediabetes, three years of continuous treatment with once-daily liraglutide, combined with diet and exercise, was associated with a lower risk of type 2 diabetes diagnosis and sustained weight loss compared with placebo, according to a study published Feb. 22 in The Lancet.

Carel W. le Roux, PhD, et al., randomized 2,254 patients in a 2:1 ratio to receive either once-daily subcutaneous liraglutide (3.0 mg) or a matched placebo, as an adjunct to a reduced calorie diet and increased physical activity, over 160 weeks. Individuals in the study were aged 18 years or older and had prediabetes and a body mass index of at least 30 kg/m2 or at least 27 kg/m2 with comorbidities. All participants received standardized lifestyle intervention counseling approximately once a month throughout the trial.

Results showed that after 160 weeks, 2 percent of individuals in the liraglutide group were diagnosed with diabetes while on treatment compared with 6 percent in the placebo group. The mean time from randomization to diagnosis for participants in the liraglutide group was approximately 99 weeks compared with 87 weeks in the placebo group. The liraglutide group also showed greater weight loss and improvements in glycemic control and cardiometabolic risk factors than the placebo group.

"Liraglutide 3.0 mg, as a GLP-1 receptor agonist, provides a different treatment option for individuals with obesity or overweight, with or without type 2 diabetes, having direct glucose-dependent effects on insulin secretion and weight-loss mediated effects on improved insulin resistance," the authors conclude. Moving forward, they explain that post-market surveillance will ensure detection of potential side effects with a low incidence.

In an accompanying comment, Olivia M. Farr, PhD, and Christos S. Mantzoros, MD, PhD, said that although liraglutide showed positive results, it may not be the most cost-effective method of reducing type 2 diabetes. They suggested that lifestyle modification, which reduces the risk of developing diabetes as well as hypertension and hyperlipidemia, appears to be equally as effective as liraglutide. "A direct comparison of intensive lifestyle modification and liraglutide would be required to determine this, and possibly, specifically designed comparative studies would be advisable to assess the effects of one, the other, or a combination of the two to advance the field," they explain.

Keywords: Blood Glucose, Body Mass Index, Comorbidity, Counseling, Diabetes Mellitus, Type 2, Diet, Exercise, Glucagon-Like Peptide 1, Hyperlipidemias, Hypertension, Incidence, Life Style, Insulin Resistance, Insulins, Obesity, Overweight, Prediabetic State, Random Allocation, Risk Factors, Weight Loss

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