Frontiers in Pharmacology (Mar 2024)

Real-world effectiveness of GLP-1 receptor agonist-based treatment strategies on “time in range” in patients with type 2 diabetes

  • Yongru Chen,
  • Jingxian Chen,
  • Jingxian Chen,
  • Shuo Zhang,
  • Shuo Zhang,
  • Dan Zhu,
  • Feiying Deng,
  • Feiying Deng,
  • Rui Zuo,
  • Yufei Hu,
  • Yue Zhao,
  • Yale Duan,
  • Benwei Lin,
  • Fengwu Chen,
  • Yun Liang,
  • Jiaxiong Zheng,
  • Barkat Ali Khan,
  • Kaijian Hou

DOI
https://doi.org/10.3389/fphar.2024.1370594
Journal volume & issue
Vol. 15

Abstract

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Background: Diabetes affects millions of people worldwide annually, and several methods, including medications, are used for its management; glucagon-like peptide-1 receptor agonists (GLP-1RAs) are one such class of medications. The efficacy and safety of GLP-1RAs in treating type 2 diabetes mellitus (T2DM) have been assessed and have been shown to significantly improve time in range (TIR) in several clinical trials. However, presently, there is a lack of real-world evidence on the efficacy of GLP-1RAs in improving TIR. To address this, we investigated the effect of GLP-1RA-based treatment strategies on TIR among patients with T2DM in real-world clinical practice.Methods: This multicenter, retrospective, real-world study included patients with T2DM who had previously used a continuous glucose monitoring (CGM) system and received treatment with GLP-1RAs or oral antidiabetic drugs (OADs). Patients who received OADs served as controls and were matched in a 1:1 ratio to their GLP-1RA counterparts by propensity score matching. The primary endpoint was the TIR after 3–6 months of treatment.Results: According to propensity score matching, 202 patients were equally divided between the GLP-1RA and OAD groups. After 3–6 months of treatment, the TIR values for the GLP-1RA and OAD groups were 76.0% and 65.7%, respectively (p < 0.001). The GLP-1RA group displayed significantly lower time above range (TAR) and mean glucose values than the OAD group (p < 0.001). Subgroup analysis revealed that, compared with the administration of liraglutide, the administration of semaglutide and polyethylene glycol loxenatide (PEG-Loxe) significantly improved TIR over 3–6 months of treatment (p < 0.05).Conclusion: These real-world findings indicate that GLP-1RA-based treatment strategies could be superior to oral treatment strategies for improving TIR among patients with T2DM and that once-weekly GLP-1RA may be more effective than a once-daily GLP-1RA.Clinical trial registration:http://www.chinadrugtrials.org.cn/index.html, identifier number ChiCTR2300073697.

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