Type II diabetes - liraglutide
A growing number of people are being diagnosed with Type II diabetes. It is often caused by poor diet and insufficient exercise, and those suffering from the condition become unable to use the insulin they produce.
A growing number of people are being diagnosed with Type II diabetes. It is often caused by poor diet and insufficient exercise, and those suffering from the condition become unable to use the insulin they produce.
While initially it can often be controlled by diet and exercise, drug therapy is generally required in the long run. Numerous treatments are available, including biguanides, sulfonylureas and the glitazone insulin sensitisers.
A new drug under development at Novo Nordisk is the GLP-1 analogue liraglutide, formerly referred to as NN-2211.1 The peptide derivative has already undergone several clinical trials. In one, a total of 193 patients with Type II diabetes were given subcutaneous doses ranging from 0.045 to 0.75mg once a day or open label glimepiride for 12 weeks. The two highest doses were significantly better than placebo at reducing fasting serum glucose levels, and as good as glimepiride.
Its effects at improving glycaemic control have also been investigated. In the trial, 144 diabetic patients were given open label metformin for 26 weeks, followed by 1g metformin twice a day or metformin with an escalating amount of liraglutide for five weeks in a double blind randomised trial.2 Those given the combination showed greater reductions in fasting blood glucose levels and bodyweight. The most common adverse event was nausea but the incidence was low and it was not treatment limiting.
Another trial in 13 patients involved treatments with 6µg/kg subcutaneous liraglumide or placebo a day for nine days.3 The drug gave significant decreases in plasma glucose concentration, while insulin secretion was unchanged. In a fourth, multicentre double blind, parallel group, double dummy study, the dose-response relationship of the drug's effects on bodyweight and glycaemic control were carried out.4 After a four-week metformin run-in period, 210 subjects were given liraglutide in one of six doses or metformin. The lowest doses did not maintain the fasting plasma glucose values achieved with metformin, but higher doses were as good.