RESPONSE OF COMBINED TREATMENTS FOR OBESITY AND TYPE 1 DIABETES WITH GLP-1
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Keywords
Type 1 diabetes, obesity, GLP-1 receptor agonists, insulin therapy, glycemic control, weight management, cardiovascular health.
Abstract
Background: T1D and obesity are both complex conditions to treat because the improvement in the patient’s insulin level through insulin therapy helps the patient gain weight in contrast to other types of diabetes. The selected GLP-1 receptor agonists have demonstrated potential for improving glycemic targets and contributing to weight loss in T2DM; thus, this study examines GLP-1RAs for T1D patients with obesity.
Aim: Using a qualitative approach, this work seeks to establish the impact of adding GLP-1 receptor agonists to insulin treatment for glycemic control, weight loss, and cardiovascular outcomes in patients with T1D and obesity.
Study Setting: The study is conducted at Pakistan Institute Of Medical Sciences (PIMS) Islamabad, from Jan 2023 - June 2023.
Method: This RCT aimed at comparing changes in metabolic characteristics of T1D obese patients treated with GLP-1 receptor agonists as an additional medication to insulin treatment. Patients were equally divided randomly and treated either with insulin or with insulin plus GLP-1 as an adjunct therapy under double blind for a duration of 24 weeks. In the experimental group, the patients received active substance liraglutide, while in the control group insulin dosages were adjusted to the normal glucose level. These were represented by shifts in the HbA1c level, weight, or cardiovascular status; two aspects of quality of life were evaluated by self-reporting instruments. Statistical software SPSS was used in data analysis and the particular focus of the study was to evaluate the effectiveness of the combination therapy as compared with insulin only.
Results: HbA1c was significantly reduced among the experimental group, (-1.2%) as compared to the (-0.4%)in the control group and weight loss (-3.5kg) as compared to control group (-0.5 kg). Furthermore, the experimental group had better cardiovascular indices, the physical signs such as blood pressure and lipid profile, and self-rating satisfaction with the treatment.
Conclusion: Supplementary use of GLP-1 receptor agonists has been shown to add to both the efficiency of glycemic control and the issue of weight in T1D obese patients under insulin treatment. They appear to point to the fact that this combined therapy, therefore, could be a worthy addition to the existing treatment paradigms with regard to these two conditions in particular. However, more investigation is required to work out these advantages with the greater and more extensive analyses.
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Syeda Quratulain Farhan
Speciality Registrar Stroke Medicine, University Hospital Coventry and Warwickshire, England
Reena Kishore Ochani
Paediatric Registrar, Zulekha Hospital, Sharjah, UAE
Samar Ali Mohamed Aboelgamal
Intensivist, Zulekha Hospital, Sharjah, UAE
Subash Kirshan
Paediatric Registrar, Hull Royal Infirmary Teaching Hospital, England
Kiran Tufail
Senior House Officer, Nottingham University Hospital, England
Dr Muhammad Zeeshan
Registrar General Medicine, Pakistan Institute of Medical Sciences (PIMS), Islamabad