Heterogeneity in response to GLP-1 receptor agonists in type 2 diabetes in real-world clinical practice: insights from the DPV register – an IMI-SOPHIA study

Le résumé fourni par la source

Abstract Aims/hypothesis Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a cornerstone in type 2 diabetes management. In this study we evaluated heterogeneity in body weight and glycaemic responses to the initiation of liraglutide, semaglutide or dulaglutide in real-world clinical practice. Methods Data from 4467 adults with type 2 diabetes in the Diabetes Patient Follow-up (DPV) registry were analysed, focusing on changes in HbA 1c and body weight over 6 months following initiation of a GLP-1 RA. We categorised participants based on their response: HbA 1c reduction only, weight loss only, both or neither. This analysis was part of the IMI-Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy (IMI-SOPHIA) project. Results At 6 months’ follow-up the median absolute HbA 1c reduction was 5.3 mmol/mol (IQR 13.9, −1.0) (0.49% [1.27, −0.09]) and relative body weight reduction was 1.43% (4.26, 0). Only 14% of participants achieved meaningful reductions in both HbA 1c (absolute reduction ≥5.5 mmol/mol [0.5%]) and body weight (relative reduction ≥5%). Men and those with a higher baseline HbA 1c were more likely to show an HbA 1c only response (36% of participants; both p <0.001), while older individuals and those with a longer diabetes duration were more likely to experience a weight-only response (7% of participants; both p <0.001). Higher baseline body weight and lower eGFR (both p <0.05) correlated with greater weight reduction, whereas lower baseline HbA 1c and longer diabetes duration were linked to smaller HbA 1c reductions (both p <0.001). Conclusions/interpretation There is significant heterogeneity in responses to GLP-1 RA therapy among individuals with type 2 diabetes in routine clinical practice. However, in our study a substantial proportion achieved a reduction in either body weight or HbA 1c . Future studies should explore why some individuals achieve either weight loss or HbA 1c reduction but not both. Graphical Abstract

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.