Short-term Effectiveness Of Low Dose Liraglutide In Combination With Metformin Versus High Dose Liraglutide Alone In Treatment Of Obese Pcos: Randomized Trial
Abstract Liraglutide 3 mg was recently approved as an anti-obesity drug. Metformin is weight neutral, yet it could enhance the therapeutic index of GLP-1 agonist. We compared weight-lowering potential of liraglutide 1.2 mg in combination with metformin to liraglutide 3 mg monotherapy in obese PCOS. Thirty obese women with PCOS (aged 33.1 ± 6.1 years, BMI 38.3 ± 5.4 kg/m2) were randomized to combination (COMBO) of metformin (MET) 1000 mg BID and liraglutide 1.2 mg QD (N = 15) or liraglutide 3 mg (LIRA3) QD alone (N = 15) for 12 weeks. The primary outcome was change in anthropometric measures of obesity. Both treatments led to significant weight loss (−3.6 ± 2.5 kg, p = 0.002 in COMBO vs −6.3 ± 3.7 kg, p = 0.001 in LIRA3). BMI and waist circumference reduction in LIRA3 was greater than in COMBO (−2.2 ± 1.3 vs −1.3 ± 0.9 kg/m2 , p = 0.05 and −4.2 ± 3.4 vs −2.2 ± 6.2 cm, p = 0.014, respectively). Both interventions resulted in a significant decrease of post-OGTT glucose levels. COMBO significantly reduced total testosterone and was associated with less nausea. Short-term interventions with COMBO and LIRA3 both led to significant improvement of measures of obesity in obese PCOS, LIRA3 being superior to COMBO. However, COMBO further improved androgen profile beyond weight reduction and was associated with better tolerability. Background Obesity is present in 50–80% of women with polycystic ovary syndrome (PCOS) [1]. Even a modest weight loss of 5–10% is primarily important for reduction of cardiovascular risk factors and improvement of fertility potential [2–4]. First line recommended lifestyle therapy for weight management often remains unsatisfactory and non-sustainable in clinical practice [5–7]. Liraglutide, a long acting glucagon-like peptide- Continue reading >>
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Victoza Side Effects
Victoza is the brand name of the drug liraglutide, which is used to control blood sugar levels in people with type 2 diabetes. Type 2 diabetes is a condition that occurs when the body doesn't use insulin properly. Victoza helps the pancreas release the correct amount of insulin when blood sugar levels spike, and it decreases the levels of glucose produced by the liver. Victoza is available as an injection that's used in conjunction with a diet and exercise plan that promotes overall health. The drug is in a class of medications known as incretin mimetics. It was approved by the Food and Drug Administration (FDA) in 2010 and is manufactured by Novo Nordisk. This medicine may reduce the risk of serious or life-threatening complications of diabetes, which include stroke, heart disease, kidney problems, nerve damage, and eye issues. However, advocacy groups have recently petitioned the FDA to remove Victoza from the market because of other serious risks the drug poses, including the risk of developing certain cancers. Victoza Warnings Victoza may increase your risk of developing tumors of the thyroid gland, including thyroid cancer. You should tell your doctor if you or anyone in your family has or has ever had thyroid cancer, medullary thyroid carcinoma (a type of thyroid cancer), or multiple endocrine neoplasia syndrome type 2 (a condition that causes tumors in more than one gland in the body). Call your doctor immediately if you experience hoarseness, difficulty swallowing, shortness of breath, or develop a lump or swelling in the neck. This medication has also been linked to pancreatitis (inflammation of the pancreas) and the development of pancreatic cancer. You should talk to your doctor about these risks. Victoza should not be used by people with type 1 diabetes or d Continue reading >>
Combined Liraglutide And Metformin Therapy In Women With Previous Gestational Diabetes Mellitus (gdm)
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Combined Liraglutide and Metformin Therapy in Women With Previous Gestational Diabetes Mellitus (GDM) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT01234649 Recruitment Status : Active, not recruiting Information provided by (Responsible Party): Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information A diagnosis of gestational diabetes mellitus (GDM)has significant implications for the future health of the mother. GDM is often the culmination of years of unrecognized and unmodified diabetes risk factors that lead to overt and occult clinical manifestations during pregnancy. Systematic reviews of older studies conclude that 35-60% women with gestational diabetes will develop type 2 diabetes (DM2) at rates much greater than control groups who did not have glucose intolerance during pregnancy. Liraglutide may potentially delay disease progression in GDM considering the beta -(-)cell function improvement in DM2 and -cell mass shown to increase in animal models. This study will examine if the addition of liraglutide to metformin therapy is more effective than metformin alone in improving insulin sensitivity and normalizing insulin secretion in at-risk overweight/obese women with prior GDM. Gestational Diabetes Mellitus Type 2 Diabetes Mellitus Metabolic Syndrome Impaired Glucose Tolerance Disorder of Glucose Regulation Drug: Metformin XR plus placebo Drug: Metformin XR plus l Continue reading >>
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![Levemir® (insulin Detemir [rdna Origin] Injection) Indications And Usage](https://diabetestalk.net/images/VVDGdQQsclkINdjV.jpg)
Levemir® (insulin Detemir [rdna Origin] Injection) Indications And Usage
Levemir® is contraindicated in patients with hypersensitivity to Levemir® or any of its excipients. Never Share a Levemir® FlexTouch® Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens. Dosage adjustment and monitoring: Monitor blood glucose in all patients treated with insulin. Insulin regimens should be modified cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment of concomitant anti-diabetic treatment. Administration: Do not dilute or mix with any other insulin or solution. Do not administer subcutaneously via an insulin pump, intramuscularly, or intravenously because severe hypoglycemia can occur. WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Victoza® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Victoza® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Victoza®. Levemir® (insulin detemir [rDNA origin] injection) Indications and U Continue reading >>
The Effect Of Insulin Detemir In Combination With Liraglutide And Metformin Compared To Liraglutide And Metformin In Subjects With Type 2 Diabetes
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. The Effect of Insulin Detemir in Combination With Liraglutide and Metformin Compared to Liraglutide and Metformin in Subjects With Type 2 Diabetes The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT00856986 Information provided by (Responsible Party): Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information This trial is conducted in Europe and North America. The aim of this clinical trial is to assess and compare the effect of insulin detemir in combination with liraglutide and metformin versus liraglutide and metformin in subjects with type 2 diabetes. Subjects will continue their own pre-trial metformin treatment during the trial. Drug: liraglutide Drug: insulin detemir Drug: metformin The Effect of Insulin Detemir in Combination With Liraglutide and Metformin Compared to Liraglutide and Metformin in Subjects With Type 2 Diabetes. A 26 Week, Randomised, Open-label, Parallel-group, Multicentre, Multinational Trial With a 26 Week Extension Subcutaneous administration of liraglutide 1.8 mg once daily in a forced 12 week run-in period + subject's own pre-trial metformin treatment at an unchanged dose and frequency (at least 1500 mg daily). Initial dose of liraglutide 0.6 mg/day with weekly increments of 0.6 mg until final dose of 1.8 mg/day was reached. Subjects were randomised to continue to receive liraglutide 1.8 mg once daily + metformin for 26 weeks plus 26 weeks extension Continue reading >>
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Liraglutide, Metformin Combination Reduces Risk For Diabetes In Postpartum Women
Liraglutide, metformin combination reduces risk for diabetes in postpartum women NEW ORLEANS The addition of liraglutide to metformin led to greater weight loss and improvements in insulin secretion and action in women who were overweight, obese and had a history of gestational diabetes when compared with metformin alone, according to study results presented at the American Diabetes Association Scientific Sessions. The combination therapy was also more effective in reducing triglyceride to HDL-cholesterol ratio and mean blood glucose levels compared with metformin monotherapy, according to the researchers. We knew that getting the weight off [in this patient population] was critical, Karen Elkind-Hirsch, PhD, MSc, HCLD, scientific director of research at Woman's Hospital in Baton Rouge, Louisiana, told Endocrine Today. That was the impetus about perhaps using a glucagon-like peptide 1 receptor agonist, because we know a side effect is weight loss. Initiating weight loss is important, Elkind-Hirsch said, because gestational diabetes mellitus (GDM) is associated with maternal obesity, and obesity and weight gain are associated with an increased risk for type 2 diabetes. Elkind-Hirsch and colleagues randomized 110 overweight women (BMI > 25 kg/m2) aged 18 to 45 years who experienced GDM within 12 months of pregnancy to either 2000 mg of metformin and 1.8 mg of subcutaneous liraglutide (Victoza, Novo Nordisk) or metformin at 2000 mg and placebo for 36 weeks. Seventy-six women completed the 32 to 36-week follow-up visit. The results demonstrated that the combination therapy was more effective in reducing BMI (P = .018), triglyceride to HDL-cholesterol ratio (P < .03) and mean blood glucose levels (P < .03). The researchers noted that impaired glucose regulation was identifi Continue reading >>
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Drug Interactions Between Metformin And Victoza
Interactions between your drugs The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply. Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. Unknown No information available. Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interac Continue reading >>
How Victoza® Works
Victoza® is different from diabetes pills because it works in 3 ways to lower blood sugar. Victoza® works in 3 ways like the hormone GLP-1 (7-37)a to help control blood sugar levels Victoza® slows food leaving your stomach. GLP-1 is normally released from your small intestine when you eat. This slows down the process of food leaving your stomach, which helps control your blood sugar after meals. Victoza® helps prevent your liver from making too much sugar. Victoza® helps the pancreas produce more insulin when your blood sugar levels are high. Victoza® does this by helping important cells work the way they should. These cells are called beta cells and they help control blood sugar by making and releasing insulin. aGLP-1 (7-37) represents <20% of the total circulating GLP-1 produced by your body. Victoza® is not insulin Victoza® is not insulin. But it can be taken with long-acting insulin. When using Victoza® with insulin, take them as separate injections. You may give both injections in the same body area (for example, your stomach area), but you should not give the injections right next to each other. Never mix insulin and Victoza® together. Victoza® may also be taken alone or in combination with one or more common oral type 2 diabetes medications. These include biguanides (such as metformin), sulfonylureas (SUs), and thiazolidinediones (TZDs). While not a weight-loss product, Victoza® may help you lose some weight In clinical studies ranging from 26 to 52 weeks in length, many people lost some weight. In our largest study, when Victoza® was added to metformin, people lost on average up to 6.2 pounds. While many people in clinical trials lost weight, some did gain weight. The American Diabetes Association recommends weight loss as an important goal for over Continue reading >>
Can Liraglutide Help Patients With Pcos Lose Weight?
Can Liraglutide Help Patients With PCOS Lose Weight? Home Blog Anti-Diabetic Can Liraglutide Help Patients With PCOS Lose Weight? Can Liraglutide Help Patients With PCOS Lose Weight? On June 17, 2013 Endocrine Today reported at the ENDO 2013 meeting that Liraglutide demonstrated success as a weight loss treatment. Combined with the antidiabetic drug Metformin, Liraglutide was administered on a short term basis to women with polycystic ovary syndrome who were considered obese. Obesity is a great problem in women with polycystic ovary syndrome (PCOS) and we do not have a conventional satisfactory treatment for it. The most widely used drug is metformin for women with PCOS and metabolic disturbances, but its somehow not successful enough to curb obesity. Thats why we tried to use our experience with diabetes to test long-acting GLP-1 agonists for any effect on the PCOS population, Jenterle Sever said in an interview. This study centered on these women with polycystic ovary syndrome, also known as PCOS, as this patient population struggles with both metabolic issues as well as weight loss frustrations. There were 36 women who participated in this randomized study, which lasted twelve weeks. The female participants were dosed with either 1.2 milligrams of Liraglutide (Victoza) as a daily subcutaneous dose, 1000 milligrams of Metformin twice daily or a combination of both medications. The average age of the female patients was 31.3 years old. Of the female participants who received the combination of both Liraglutide and Metformin 22 percent of these women lost more than 5 percent of their body weight. For the female patients who were dosed with Liraglutide there were 16 percent of these women who achieved a weight loss of greater than 5 percent of their total body weight. T Continue reading >>
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Liraglutide In Combination With Metformin Or Sulfonylurea For The Treatment Of Type 2 Diabetes In Adult Patients
Type 2 diabetes is a progressive disease characterized by decline in β-cell function and insulin resistance. The development of liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, has been shown in clinical trials to be an effective drug with beneficial effects on β-cell function and improved glycemic control, without the side effects of weight gain and hypoglycemia that frequently limit the use of oral anti-diabetic drugs. Furthermore, its prolonged half-life makes it suitable for once daily administration. Liraglutide is demonstrated to be an effective agent in combination with commonly used oral antidiabetic drugs such as metformin and sulphonylureas, with a significant number of patients achieving their glycemic targets without hypoglycemia. In this review, the results from clinical trials utilizing liraglutide in combination with metformin or sulphonylurea are summarized with regards to efficacy and safety. 1. International Diabetes Federation. Epidemiology and morbidity: Diabetes and impaired glucose tolerance. Available at: 2011. Accessed Mar 3, 2012. Google Scholar 2. World Health Organization (2008) fact sheet No 312: Diabetes. Available at: 2012. Accessed Mar 3, 2012. Google Scholar 3. Nathan, D.M., Buse, J.B., Davidson, M.B.. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009; 32(1): 193–203. Google Scholar 4. Wajchenburg, B.L. Beta-cell failure in diabetes and preservation by clinical treatment. Endocr Rev. 2007; 28(2): 187–218. Google Scholar 5. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood glucose control wit Continue reading >>
The Efficacy And Safety Of Liraglutide Added To Metformin In Patients With Diabetes: A Meta-analysis Of Randomized Controlled Trials
Liraglutide, a glucagon-like peptide (GLP-1) receptor agonist, has showed favorable effects in the glycaemic control and weight reduction in patients with type 2 diabetes mellitus (T2DM). The meta-analysis was to compare the efficacy and safety of liraglutide added to metformin with other treatments in patients with T2DM. A systematic literature search on PubMed, Embase, Web of Science and the Cochrane library databases were performed. Eligible studies were randomized controlled trials (RCTs) of patients with T2DM who received the combination treatment of liraglutide and metformin. Pooled estimates were performed using a fixed-effects model or random-effects model. A total of nine RCTs met the inclusion criteria. Compared with control (placebo, sitagliptin, glimepiride, dulaglutide, insulin glargine, and NPH), liraglutide in combination with metformin resulted in significant reductions in HbA1c, bodyweight, FPG, and PPG, and similar reductions in SBP, and DBP. Moreover, liraglutide combined with metformin did not increase the risk of hypoglycemia, but induced a higher incidence of gastrointestinal disorders. In conclusion, this meta-analysis confirmed the use of liraglutide as add-on to metformin appeared to be effective and safe for patients with T2DM. However, considering the potential limitations in this study, more large-scale, well-conducted RCTs are needed to identify our findings. Type 2 diabetes mellitus (T2DM) is a complex and progressive multi-system disease characterized by declining beta cell function and insulin resistance, which lead to loss of glycemic control and eventual diabetes complications1,2. Lifestyle modifications and metformin have been recommended by the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EAS Continue reading >>
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Victoza Weight Loss Case Study: 50 Pounds Lost With Victoza + Ldn & More (updated)
Victoza is a powerful weight loss meidcation that ACTUALLY works... If used correctly. And I will explain what I mean by that a little bit later, but first we need to talk about this case study. During this time she was able to lose almost 40 pounds using my hormone balancing approach with the combination of Victoza + LDN + NDT and other hormones which we will discuss below. You can see her email to me below... Before we talk about how to lose this kind of weight when you have hormone imbalances like hypothyroidism or insulin resistance we need to talk about Victoza... I am happy to report that this patient is now down another 10 pounds over the last month and is now down 50 pounds total thus far. I suspect she will keep losing and I will update this again once I have some before/after pictures and more progress to report! This new set of weight loss occurred without any changes to her treatment plan. You can find more about using the same weight loss program that this patient used by clicking here. Victoza Weight Loss Success: Does it Work? For the benefit of those who are unfamiliar with Victoza let me give you a brief explanation of what it is. Victoza is a prescription medication (FDA approved for type II diabetes - but we will talk more about who else can benefit from this medication later) which targets the GLP-1 receptor. Put another way the medication helps balance glucagon levels leading to more stable blood sugar levels. So why do some patients lose a considerable amount of weight while using this medication? In addition to the effects that it has on glucagon it is also a powerful medication at lowering leptin levels and reducing insulin resistance. If you've been reading the information out on my blog you know that these two hormone imbalances (along wi Continue reading >>
Victoza May Help With Weight In Ovary Disorder
SAN FRANCISCO -- Adding the diabetes drug liraglutide (Victoza) to metformin might be beneficial for obese women with polycystic ovary syndrome (PCOS), a pilot study showed. The combination of liraglutide and metformin induced a significantly greater amount of weight loss through 12 weeks compared with liraglutide or metformin monotherapy (14.3 versus 8.4 and 2.6 pounds, P=0.001), according to Mojca Jensterle Sever, MD, PhD, of the University Medical Center in Ljubljana, Slovenia. The percentage of patients who lost at least 5% of their body weight was 22% in the combination group, 16% in the liraglutide group, and 0% in the metformin group, she reported at the Endocrine Society meeting here. In an interview, Jensterle Sever said that this was the first study to examine the use of a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist in women with PCOS. GLP-1 agonists have been shown to lead to weight loss in patients with diabetes. The use of liraglutide as an add-on to metformin in women with PCOS deserves further investigation in larger randomized studies with long-term follow-up, she said, acknowledging that the study presented was small with just 36 patients. "It's not strong enough to change treatment strategies," she said, noting that liraglutide is approved only for use in patients with type 2 diabetes. Studies with long-term follow-up are particularly important, she said, because maintenance of the observed weight loss might be an issue. The mechanism by which GLP-1 agonists induce weight loss is likely through suppression of appetite and a delay in gastric emptying, she said, so patients might eat more and gain the weight back after stopping the drug. Obesity is common in women with PCOS and shedding weight has been shown to improve reproductive and m Continue reading >>
Liraglutide, Metformin Combination Yields Weight Loss In Obese Pcos Patients
Liraglutide, metformin combination yields weight loss in obese PCOS patients Rasmussen CB. Front Endocrinol. 2014;doi:10.3389/fendo.2014.00140. In overweight and obese women with polycystic ovary syndrome , a regimen of liraglutide, combined with metformin and lifestyle changes, yielded significant weight loss, according to recent findings. In the observational study, researchers evaluated 84 overweight or obese women with PCOS (mean age, 35.5 years) undergoing liraglutide treatment between January 2010 and August 2012 at a private gynecology and fertility facility. All patients had been diagnosed with PCOS based on the Rotterdam criteria and had failed to lose weight on a regimen of metformin and lifestyle modification. The researchers recorded the following clinical variables for all patients: date of first prescription, weight at liraglutide initiation, height, dose of liraglutide and weight loss at clinical follow-up. Patients followed a lifestyle modification program consisting of a low glycemic diet with no caloric restriction, assistance from a dietician and advice to participate in 45 minutes of moderate physical exercise three times per week. At baseline, 81.7% of the patients were obese (BMI 30 kg/m2) and 18.3% were overweight (BMI 25-30 kg/m2). Patients underwent the liraglutide regimen for a minimum of 4 weeks. The researchers found at follow-up the mean weight loss of liraglutide/metformin treated patients was 9.0 kg (P<.0001) and the mean BMI reduction was 3.2 kg/m2 (P<.001). A total of 81.7% of patients achieved weight loss of more than 5% of baseline weight and 32.9% attained weight loss of more than 10% of their baseline weight. Patients were treated with liraglutide for a mean duration of 27.8 weeks. Side effects were reported by 22.6% of patients and Continue reading >>
Diabetes Treatment, Type 1 & 2: Medications, Guidelines & Diet
Bydureon is a longer acting from of exenatide that is injected once weekly. During April 2014, FDA approved albiglutide as an injectable monotherapy for adults with type 2 diabetes. Liraglutide and albiglutide share the same mechanism of action and similar side effect profiles. Eight clinical trials involving over 2,000 participants with type 2 diabetes showed improved HbA1c with albiglutide. Albiglutide has been studied as monotherapy and in combination with metformin, glimepiride, pioglitazone, or insulin. Albiglutide should not be used in patients with type 1 diabetes and those with risk for, family history of, or personal history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (which predisposes to MTC). During September 2014, FDA approved dulaglutide as an injectable monotherapy for adults with type 2 diabetes. Liraglutide, albiglutide, and dulaglutide are all GLP-1 receptor agonists and share similar side effect profiles. Dulaglutide improved HbA1c level in 6 clinical trials involving over 3,300 participants with type 2 diabetes. Dulaglutide has been studied as monotherapy and in combination with metformin, sulfonylurea, thiazolidinedione, or prandial insulin. Dulaglutide should not be used in patients with type 1 diabetes and those with risk for, family history of, or personal history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (which predisposes to MTC). Dulaglutide should also not be used as first-line therapy for type 2 diabetes patients who cannot be managed with diet and exercise. DPP-IV inhibitors (sitagliptin, saxagliptin, linagliptin) The body breaks down GLP-1 by an enzyme called DPP IV. Logically, one could make either a synthetic GLP-1 that cannot be broken down by this enzyme (fo Continue reading >>
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