Glucagon-like peptide-1 (GLP-1) receptor agonists like liragutide lead to better perioperative blood sugar control in diabetes when added to insulin ,finds a new study.
Addition of GLP-1 agonist liraglutide to insulin helped in better management of perioperative blood sugar levels in type 2 diabetes patients undergoing elective cardiac surgery than insulin alone, suggests a recent study published in the journal Diabetic Medicine.
Glucagon-like peptide-1 (GLP-1) receptor agonists are approved for use in achieving blood sugar control. They promote insulin secretion and suppress glucagon secretion during hyperglycemia, but they do not act during hypoglycemia, Therefore, they can decrease the blood sugar levels without posing any risk for hypoglycemia.
Diabetes is a risk factor for perioperative complications and deaths in cardiovascular surgeries this is because increased levels of blood sugar (hyperglycemia) is associated with a delay in wound healing, infection and acute kidney injury. Also, postoperative neurocognitive disorders can result in people who had high blood sugar levels during the peri-operative period. Therefore, the prevention of high blood sugar or hyperglycemia during the perioperative period becomes important. Previous studies have shown the importance of achieving glycemic control without hypoglycemia for improving the mortality rate in patients undergoing cardiac surgery.
H. Makino, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan, and colleagues set out to determine whether the addition of GLP‐1 receptor agonist can decrease glucose levels without increasing the hypoglycemia risk and whether it will help to achieve appropriate glycaemic control during the peri‐operative period.
The study involved 70 people with type 2 diabetes who underwent elective cardiac surgery. The participants were randomized to receive either insulin alone or insulin plus liraglutide 0.6 mg/day group. M values that indicated the proximity index of the target glucose level from day 1 to day 10 were then evaluated.
Key findings include:
- The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3).
- The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group.
- The frequency of hypoglycemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group.
“Our results showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period,” concluded the authors.
To read the complete study log on to https://doi.org/10.1111/dme.14084