Real‐world use of glucagon‐like peptide‐1 receptor agonists in youth with type 2 diabetes is associated with short‐term improvements in HbA1c

Jan 17, 2024Diabetes, obesity & metabolism

Real-world use of GLP-1 drugs in young people with type 2 diabetes is linked to short-term blood sugar improvements

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Abstract

A total of 136 patients with type 2 diabetes showed a decrease in HbA1c levels after using GLP-1 receptor agonists.

HbA1c levels decreased from 7.9% to 7.6% at a median follow-up of 91 days.
Among patients with HbA1c data at baseline and second follow-up, levels dropped from 8.4% to 7.4%.
The proportion of patients prescribed basal insulin decreased from 69% to 60% and prandial insulin from 46% to 38% at the first follow-up.
There was a mean decrease in HbA1c of 0.09 percentage points per month in multivariable analysis.
Real-world use of GLP-1 receptor agonists is associated with reduced insulin requirements in youth with type 2 diabetes.

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AIM: To assess the short-term, real-world use and effectiveness of glucagon-like peptide-1 receptor agonist (GLP-1RA) medications in the management of type 2 diabetes (T2D) in a diverse cohort of youth.

METHODS: This multicentre retrospective study analysed youth prescribed a GLP-1RA for the management of T2D at two academic paediatric diabetes centres prior to June 2022. Change in HbA1c and insulin use from baseline to first (median 91 days) and second (median 190 days) follow-up were evaluated for those taking a GLP-1RA. Multivariable linear mixed effects models adjusting for baseline sex, age, race/ethnicity, insurance, insulin regimen, metformin regimen, GLP-1RA dosing frequency and the body mass index Z-score (BMI-Z) examined the change in HbA1c for participants for up to 6 months after baseline.

RESULTS: A total of 136 patients with T2D (median age 16.1 [interquartile range 13.9-18.0] years, 54% female, 56% non-Hispanic Black, 24% Hispanic, 77% with public insurance) were prescribed GLP-1RAs and taking them at first or second follow-up. Median HbA1c decreased from 7.9% to 7.6% (P < .001) at a median follow-up of 91 days (n = 109) and, among those with HbA1c available at baseline and second follow-up (n = 83), from 8.4% to 7.4%. The proportion of patients prescribed insulin decreased from baseline to the first follow-up visit (basal 69% to 60% [P = .008], prandial 46% to 38% [P = .03]). In multivariable analysis, there was a mean decrease in HbA1c by 0.09 percentage points per month (P = .005, 95% confidence interval -0.15, -0.03).

CONCLUSIONS: Real-world use of GLP-1RAs in youth with T2D is associated with decreased HbA1c levels, despite challenges with access and adherence. GLP-1RA treatment may reduce insulin doses for youth with T2D.

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Real‐world use of glucagon‐like peptide‐1 receptor agonists in youth with type 2 diabetes is associated with short‐term improvements in HbA1c

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