Combination therapy of glucagon‐like peptide‐1 receptor agonists and insulin for patients who developed diabetes after partial pancreatectomy

• Published in: Journal of diabetes investigation 2016-05, Vol.7 (3), p.381-385
• Main Authors: Kitazawa, Toru, Yokoyama, Kazuhito, Kubota, Ken
• Format: Article
• Language: English
• Subjects: Adipose Tissue - drug effects; Aged; Aged, 80 and over; Agonists; Blood Glucose - drug effects; Blood Glucose - metabolism; Body Weight - drug effects; Cancer therapies; Clinical Trial; Clinical trials; Diabetes; Diabetes mellitus; Diabetes Mellitus - prevention & control; Drug Therapy, Combination - adverse effects; Fasting; Female; Glucagon; Glucagon-Like Peptide-1 Receptor - agonists; Glucose; Glycated Hemoglobin A - metabolism; Hemoglobin; Humans; Hypoglycemia; Hypoglycemic Agents - therapeutic use; Immunoreactivity; Infectious diseases; Insulin; Insulin Glargine - adverse effects; Insulin Glargine - therapeutic use; Japan; Lixisenatide; Male; Pancreas; Pancreatectomy; Pancreatectomy - adverse effects; Patients; Peptides; Peptides - adverse effects; Peptides - therapeutic use; Postoperative Complications; Postprandial Period - drug effects; Risk; Standard deviation; Statistical analysis; Studies; Treatment Outcome
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.12423

Aims/Introduction It is known that after pancreatectomy, patients experience hyposecretion of endogenous insulin and frequently develop diabetes. However, it has been unclear whether combination therapy with glucagon‐like peptide‐1 receptor agonists and basal insulin is effective for such patients. In the present study, we evaluated the efficacy and safety of combination therapy with long‐acting insulin glargine and the glucagon‐like peptide‐1 receptor agonist lixisenatide in patients who developed diabetes after pancreatectomy. Materials and Methods Japanese patients who developed diabetes after pancreatectomy were eligible for this study. Participants were treated with combination therapy of glargine and lixisenatide for 12 weeks. Fasting and postprandial plasma glucose, C‐peptide immunoreactivity, glycated hemoglobin, bodyweight, visceral fat and subcutaneous fat were measured. Results At 12 weeks after initiation of lixisenatide, glycated hemoglobin levels decreased from 8.46 ± 1.64% to 6.81 ± 1.15%. In addition, 1‐h postprandial plasma glucose and 2‐h postprandial plasma glucose levels significantly decreased from 222.9 ± 56.2 mg/dL to 125.1 ± 37.5 mg/dL (P < 0.001) and from 247.5 ± 56.8 mg/dL to 115.1 ± 29.0 mg/dL (P < 0.001), respectively. Neither hypoglycemia nor clinically relevant adverse events occurred during this study. Conclusions The present study shows that combination therapy with basal insulin and glucagon‐like peptide‐1 receptor agonists after partial pancreatectomy can be a useful therapeutic option for providing effective glycemic control with a reduced risk of hypoglycemia. Combination of insulin and lixisenatide provides effective glycemic control after partial pancreatectomy.