Continuous subcutaneous insulin infusion combined with liraglutide reduced glycemic variability and oxidative stress in type 2 diabetes mellitus: a study based on the flash glucose monitoring system
Open accessAbstract
We aimed to explore the use of the flash glucose monitoring (FGM) system in hospitalized newly diagnosed type 2 diabetes mellitus (T2DM) patients and to evaluate a new combination therapy of continuous subcutaneous insulin infusion (CSII) with or without liraglutide. This was an open-label, randomized study that was conducted in 60 newly diagnosed T2DM patients. The patients were randomized to receive either CSII (n = 30) or CSII + liraglutide (n = 30). The FGM system was used to assess the glycemic control and glycemic variability (GV) indices for 2 weeks. Mean blood glucose concentration (MBG), estimated hemoglobin A1c (HbA1c), and measures of GV, including the standard deviation of the mean glucose (SD), coefficient of variation (CV), interquartile range (IQR), mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE), and mean of daily difference (MODD) were compared between the two groups. Two oxidative stress biomarkers, 4-hydroxynonenal (4-HNE) and 8-hydroxydeoxyguanosine (8-OHdG), were measured before and after treatment. The estimated HbA1c and MBG decreased in both groups, especially the CSII + liraglutide group. SD, IQR, LAGE, and MODD were significantly lower in the CSII + liraglutide group than in the CSII group (all p < 0.05); there was no difference in CV or MAGE (p > 0.05). Similarly, the 4-HNE and 8-OHdG levels were significantly lower in the CSII + liraglutide group (p < 0.05). Our findings suggest that CSII with liraglutide was superior to CSII monotherapy in improving glycemic control and glycemic variability and in decreasing oxidative stress markers. Flash glucose monitoring can successfully provide ambulatory glucose profile data in the real world.
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Some studies found that inflammatory markers rapidly decreased within weeks of starting GLP-1 RA treatment, prior to significant weight loss.
“Second, prior to significant weight loss, some studies found that inflammatory markers rapidly decreased within weeks of starting treatment (6, 17, 30).”
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“In the present study, TIR, TBR, MBG, LAGE, and SDBG were significantly improved when STII+EMPA therapy was used, compared to STII therapy alone, demonstrating that the combination was able to better narrow GV, which is similar to the finding of a previous study based on FGM [19].”
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“In another study [107] Liraglutide (a GLP-1 receptor agonist) add-on therapy to continuous subcutaneous insulin infusion (CSII), not only led to ameliorated glycemic control but also lowered the glycemic variability and OS in poorly controlled newly diagnosed T2DM.”
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- Authors
- Li, L.-Q., Yao, M.-Y., Ma, J.-X., Xue, P., & Li, Y.-K.
- Affiliations
- Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
- Third Hospital of Hebei Medical University (CN)
- ORCID
- Xue, Peng
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2019
- Volume
- 66
- Issue
- 10
- Pages
- 871-880
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2954004860
- Cited by
- 20
- References
- 36
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 2 · 2021: 3 · 2020: 5 · 2019: 1
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- insulin pump therapy, liraglutide, type 2 diabetes, glycemic variability, oxidative stress, flash glucose monitoring, newly diagnosed diabetes, glycemic control, 4-hydroxynonenal, 8-hydroxy-2'-deoxyguanosine
- MeSH terms
- Liraglutide, Adult, Aged, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Oxidative Stress, Infusions, Subcutaneous
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