Efficacy and Safety Comparison of Liraglutide, Glimepiride, and Placebo, All in Combination With Metformin, in Type 2 Diabetes
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OBJECTIVE: The efficacy and safety of adding liraglutide (a glucagon-like peptide-1 receptor agonist) to metformin were compared with addition of placebo or glimepiride to metformin in subjects previously treated with oral antidiabetes (OAD) therapy. RESEARCH DESIGN AND METHODS: In this 26-week, double-blind, double-dummy, placebo- and active-controlled, parallel-group trial, 1,091 subjects were randomly assigned (2:2:2:1:2) to once-daily liraglutide (either 0.6, 1.2, or 1.8 mg/day injected subcutaneously), to placebo, or to glimepiride (4 mg once daily). All treatments were in combination therapy with metformin (1g twice daily). Enrolled subjects (aged 25-79 years) had type 2 diabetes, A1C of 7-11% (previous OAD monotherapy for > or =3 months) or 7-10% (previous OAD combination therapy for > or =3 months), and BMI < or =40 kg/m(2). RESULTS: A1C values were significantly reduced in all liraglutide groups versus the placebo group (P < 0.0001) with mean decreases of 1.0% for 1.8 mg liraglutide, 1.2 mg liraglutide, and glimepiride and 0.7% for 0.6 mg liraglutide and an increase of 0.1% for placebo. Body weight decreased in all liraglutide groups (1.8-2.8 kg) compared with an increase in the glimepiride group (1.0 kg; P < 0.0001). The incidence of minor hypoglycemia with liraglutide ( approximately 3%) was comparable to that with placebo but less than that with glimepiride (17%; P < 0.001). Nausea was reported by 11-19% of the liraglutide-treated subjects versus 3-4% in the placebo and glimepiride groups. The incidence of nausea declined over time. CONCLUSIONS: In subjects with type 2 diabetes, once-daily liraglutide induced similar glycemic control, reduced body weight, and lowered the occurrence of hypoglycemia compared with glimepiride, when both had background therapy of metformin.
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Past GLP-1 RA studies reported mean weight change ranging from −1.0 kg to −3.78 kg over 6-12 months.
“In these studies, mean weight change ranged from −1.0 kg to −3.78 kg over 6–12 months.”
From Real-world weight change, adherence, and discontinuation among patients with type 2 diabetes initiating glucagon-like peptide-1 receptor agonists in the UK (2022) · cites this paper as [16]
The Results > Efficacy section reports mean weight losses of 1.8, 2.6, and 2.8 kg in the liraglutide groups over 26 weeks, supporting weight loss over approximately six months. It does not establish the claimed −1.0 to −3.78 kg range or a 12-month result; its 1.0 kg figure is weight gain in the glimepiride group. (LLM, conf=0.86)
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Action and therapeutic potential of oxyntomodulin
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Advances in the Treatment of Type 2 Diabetes Mellitus
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- Authors
- Nauck, M., Frid, A., Hermansen, K., Shah, N. S., Tankova, T., Mitha, I. H., Zdravkovic, M., Düring, M., Matthews, D. R., & for the LEAD-2 Study Group
- Affiliations
- Diabeteszentrum Bad Lauterberg (DE)
- Öresund Diabetes Team AB, Lund, Sweden
- Aarhus University Hospital (DK)
- King Edward Memorial Hospital and Seth G.S. Medical College (IN)
- Clinic of Diabetology, Sophia, Bulgaria
- Benmed Hospital, Benoni, Republic of South Africa
- Novo Nordisk (Denmark) (DK)
- Novo Nordisk, Bagsvaerd, Denmark
- Oxford Centre for Diabetes, Endocrinology and Metabolism (GB)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-01-01
- Volume
- 32
- Issue
- 1
- Pages
- 84-90
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2606836
- OpenAlex
- W2071835038
- Cited by
- 1,129
- References
- 26
- Citations by year
- 2026: 22 · 2025: 43 · 2024: 26 · 2023: 33 · 2022: 17 · 2021: 28 · 2020: 30 · 2019: 35 · 2018: 38 · 2017: 58 · 2016: 85 · 2015: 84 · 2014: 95 · 2013: 81 · 2012: 113
- FWCI
- 82.01
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0508-10272)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- liraglutide, glimepiride, metformin, type 2 diabetes, GLP-1 receptor agonists, combination therapy, glycemic control, HbA1c, weight loss, hypoglycemia, nausea, oral antidiabetic drugs, drug safety, obesity, dose comparison
- MeSH terms
- Liraglutide, Adult, Aged, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Obesity, Placebos, Safety, Sulfonylurea Compounds, Glucagon-Like Peptide 1
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