Important Type 2 Diabetes Results Reported

Living With Diabetes, Research | Diabetes Research, Drug Study, Type 2 Diabetes

Author: Dr. Tom Elliott

Today the results of 2 important studies in Type 2 diabetes presented at the annual American Diabetes Association meeting in New Orleans this week were published in the prestigious New England Journal of Medicine.

The LEADER study examined the outcomes of 9,340 patients with Type 2 diabetes followed for four years. All took standard diabetes medication; in addition half took liraglutide “Victoza” and the other half placebo.  Patients receiving Victoza were 15% less likely to die and 13% less likely to have the composite outcome of death/heart attack/stroke than patients receiving placebo.   

Commentary from Dr. Tom Elliott at BCDiabetes: Victoza is a very useful drug in the management of Type 2 diabetes as it lowers both sugar and weight.   This study establishes a very strong scientific & clinical rationale for the use of Victoza that goes beyond improvements in laboratory tests and weighing scales.  Victoza is given by daily injection and at full doses costs approximately $10 per day.  One of the challenges in the use of Victoza is that it is difficult to predict whether a patient will experience weight loss or improved sugar control.  Only 30% of patients get strong improvements while up to 15% will experience significant gastrointestinal side effects. To that end BCDiabetes is conducting a study with the intention of developing biomarkers for responsiveness to Victoza.  If successful this will lead to the availability of a blood test that would be given to patients before being treated with Victoza such that only those 30% likely to respond well would be given the drug.

The EMPA-REG Renal study extended the results of EMPA-Reg reported last year.  This study examined the outcomes of 4124 patients with Type 2 diabetes and a history of previous heart attack or stroke who were followed for 3+ years.  All received standard diabetes medication; in addition two thirds took empagliflozin “Jardiance” in 2 different doses and a third took placebo.   Previously reported was a 32% reduction in overall mortality for patients who took empagliflozin.  This update reported a 32% reduction in the development of significant worsening of kidney disease as well as major reductions in other kidney disease endpoints for those treated with empagliflozin compared to placebo.

Commentary from Dr. Tom Elliott:  This and the earlier EMPA-Reg study establish empagliflozin as a cornerstone treatment of high risk individuals with Type 2 diabetes.  Given the underlying efficacy of this class of drug in lowering sugar and weight, empagliflozin and to a lesser extent the other two members of the SLGLT-2 inhibitor class (dapagliflozin and canagliflozin) should be considered as a treatment for all individuals with Type 2 diabetes.