engleski

Factors Predicting GLP-1 Receptor Agonists Efficacy in Type 2 Diabetes Mellitus Treatment: A Retrospective Observational Study

As glucagon-like peptide-1 receptor agonists (GLP-1 RA) are widely used to achieve glycaemic control in patients with type 2 diabetes, early identification of GLP-1 RA responders is of special clinical interest. We evaluated biochemical and clinical characteristics in GLP-1 RA responders and non-responders (defined by switching to insulin therapy at any time after intervention) during 28 months treatment. Among 276 subjects, 73.18 % were responders. Compared to non-responders they were younger (57.92 vs 59.69 years, p=0.001), had higher BMI (39.08 vs 38.62 kg/m2, p=0.001), waist circumference (123.42 vs 120.25 cm, p=0.001), A1c (Table), C-peptide (0.92 vs 0.79 ng/mL, p<0.001) while shorter disease duration (10.54 vs 13.26 years, p=0.009). Improvement in cardiovascular (CV) risk factors was observed in both groups, but patients with severe hypertension, dyslipidaemia and history of coronary artery disease (CAD) (25.67 vs 5.94%, p=0.001) failed to maintain glycaemic control with GLP-1 RA. An A1c reduction of ≥15% after 3 months showed the best predictive value in identifying responders to GLP-1 RA (HR 1.55 ; 1.47-3.01), while the history of CAD showed negative predictive value (HR 0.27 ; 0.185-0.403). Patients with higher CV risk factors failing to reach ≥15% A1c decrease 3 months after the introduction of GLP-1 RA might be unlikely to maintain long-term glycaemic control.

glucagon-like receptor-1 agonists; type 2 diabetes mellitus

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