Liraglutide Hospital Discharge Trial: A Randomized Controlled Trial Comparing the Safety and Efficacy of Liraglutide versus Glargine Insulin for the Management of Patients with Type 2 Diabetes After Hospital Discharge.

BACKGROUND Few studies have focused on pharmacologic diabetes therapy adjustments at hospital discharge. This randomized clinical trial compared a GLP-1 receptor analog with basal insulin at hospital discharge in patients with uncontrolled type 2 diabetes. METHODS A total of 273 patients with HbA1c 7-10% were randomised to liraglutide (n = 136) or glargine (n = 137) at hospital discharge. The primary endpoint was difference in HbA1c at 12 and 26 weeks. Secondary endpoints included hypoglycaemia, changes in body weight, and achievement of HbA1c <7% without hypoglycaemia or weight gain. RESULTS Between-group HbA1c difference at 12 weeks and 26 weeks was -0.28%, 95%CI: (-0.64, 0.09), and 26 weeks was -0.55%, 95%CI (-1.01, -0.09) in favour of liraglutide. Liraglutide treatment resulted in lower frequency of hypoglycaemia <3.9 mmol/L (13% vs 23% p = 0.04), but there was no difference in the rate of clinically significant hypoglycaemia <3.0 mmol/L. Compared to glargine, liraglutide treatment was associated with greater weight loss at 26 weeks (-4.7 ± 7.7 Kg vs. -0.6 ± 11.5 kg, p < 0.001) and in the proportion of patients with HbA1c <7% without hypoglycaemia was 48% vs 33% (p = 0.05) at 12 weeks and 45% vs 33% (p = 0.14) at 26 weeks in liraglutide vs glargine insulin. The proportion of patients with HbA1c <7% without hypoglycaemia and no weight gain were higher with liraglutide at 12 (41% vs 24%, p = 0.005) and 26 weeks (39% vs 22%, p = 0.014). The incidence of gastrointestinal adverse events was higher with liraglutide than with glargine (p < 0.001). CONCLUSION Compared to insulin glargine, treatment with liraglutide at hospital discharge resulted in better glycaemic control and greater weight loss, but increased gastrointestinal adverse events. This article is protected by copyright. All rights reserved.