Use of flash glucose-sensing technology in patients with type 2 diabetes treated with liraglutide combined with CSII: a pilot study

• Published in: Brazilian journal of medical and biological research Vol. 53; no. 1; p. e8652
• Main Authors: Yao, Ming-yan, Li, Li-qin, Ma, Jian-xia, Xue, Peng, Li, Yu-kun
• Format: Journal Article
• Language: English
• Published: Brazil Revista Brasileira de Pesquisas Medicas 01.01.2020; Associação Brasileira de Divulgação Científica
• Subjects: Adiponectin; Adult; Antidiabetics; BIOLOGY; Blood Glucose Self-Monitoring - methods; Cardiometabolic risk markers; Chemoreception; Continuous subcutaneous insulin infusion; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Female; Flash glucose monitoring; Glucagon; Glucagon-like peptide 1; Glucagon-like peptide-1 analog; Glucose; Glucose fluctuation; Glucose monitoring; Heme; Heme oxygenase (decyclizing); Humans; Hyperglycemia; Hypoglycemia; Hypoglycemic Agents - administration & dosage; Insulin; Insulin - administration & dosage; Insulin Infusion Systems; Leptin; Liraglutide - administration & dosage; Male; MEDICINE, RESEARCH & EXPERIMENTAL; Metformin; Middle Aged; Oxidative stress; Oxygenase; Pilot Projects; Type 2 diabetes; Type 2 diabetes; Glucose fluctuation; Flash glucose monitoring; Cardiometabolic risk markers; Glucagon-like peptide-1 analog; Continuous subcutaneous insulin infusion
• ISSN: 0100-879X; 1414-431X; 1414-431X; 1678-4510
• DOI: 10.1590/1414-431x20198652

Glycemic variability (GV) may be linked to the development of diabetic complications by inducing inflammation, oxidative stress, and endothelial dysfunction. Flash glucose monitoring (FGM) provides a novel method of continuously monitoring interstitial glucose levels for up to 14 days. This study randomly assigned poorly controlled type 2 diabetes mellitus patients treated with metformin and multiple daily injections of insulin (n=60) to either continuous subcutaneous insulin infusion (CSII) treatment or CSII in combination with liraglutide (CSII+Lira) treatment for 14 days during hospitalization. GV was assessed using a FGM system; weight and cardiometabolic biomarkers were also evaluated. The coefficient of variation was significantly reduced in the CSII+Lira group (P<0.001), while no significant change was observed in the CSII group. The changes differed significantly between the two groups in mean amplitude of glycemic excursions (P=0.004), standard deviation (P=0.006), and the percentage of time in the target range (4-10 mmol/L, P=0.005 and >10 mmol/L, P=0.028). The changes in mean of daily differences, interquartile range, and percentage of time in hypoglycemia (<3.3 mmol/L) and hyperglycemia (>13.9 mmol/L) identified by FGM showed no difference. Treatment with liraglutide increased serum adiponectin [33.5 (3.5, 47.7) pg/mL, P=0.003] and heme oxygenase-1 levels [0.4 (-0.0, 1.8) ng/mL, P=0.001] and reduced serum leptin levels [-2.8 (3.9) pg/mL, P<0.001]. Adding the glucagon-like peptide-1 analog liraglutide improved GV, weight, and some cardiometabolic risk markers. The FGM system is, therefore, shown to be a novel and useful method for glucose monitoring.