Levin PA, et al. – Researchers conducted a literature search applying MEDLINE and Embase databases to distinguish papers comparing glucagon–like peptide–1 receptor agonists with other classes of glucose–lowering therapy in patients with type 2 diabetes. It was showed that glucagon–like peptide–1 receptor agonists are an effective class of glucose–lowering drugs for type 2 diabetes.

Methods

• Researchers performed a literature search applying MEDLINE and Embase databases to identify papers comparing glucagon-like peptide-1 receptor agonists (GLP-1RAs) with other classes of glucose-lowering therapy in patients with type 2 diabetes (T2D).
• Of the 1303 papers distinguished, 57 met the prespecified criteria for a high-quality clinical trial or retrospective study.
• They compared the adequacy and tolerability of approved GLP-1RAs (exenatide twice daily or once weekly, dulaglutide, liraglutide, lixisenatide, and albiglutide) with insulin products (23 prospective studies + seven retrospective studies), dipeptidyl peptidase-4 inhibitors (11 prospective studies + three retrospective studies), sulfonylureas (nine prospective studies + one retrospective study), thiazolidinediones (five prospective studies), and metformin (two prospective studies).

Results

• They recorded that GLP-1RAs are effective as a second-line therapy in improving glycemic parameters in patients with T2D.
• As evidence accumulates, reductions in glycated hemoglobin from baseline with GLP-1RAs tended to be greater or similar compared with insulin therapy.
• The data indicated that GLP-1RAs were consistently more effective in reducing body weight than most oral glucose-lowering drugs and insulin and were associated with lower hypoglycemia risk versus insulin or sulfonylureas.
• It was demonstrated that GLP-1RAs enhanced cardiovascular risk factors, and preliminary data indicated improve cardiovascular outcomes in patients with T2D compared with oral glucose-lowering drugs.
• Nevertheless, outcomes from ongoing studies are awaited to confirm these early findings.