Liraglutide-Induced Weight Loss May be Affected by Autonomic Regulation in Type 1 Diabetes

Conclusions: The overall CAN diagnosis was not associated with liraglutide-induced weight loss in overweight patients with type 1 diabetes. Assessed separately, better outcomes for several CAN measures were associated with higher weight loss, indicating that autonomic involvement in liraglutide-induced weight loss may exist. Introduction Glucagon-like peptide-1 (GLP-1) is a gut-derived hormone with anorexigenic properties (1). The GLP-1 receptor agonist (GLP-1RA) liraglutide is known to induce weight loss in patients with type 2 diabetes as well as in patients with type 1 diabetes (2–5). However, the exact mechanisms by which GLP-1 exerts its anorectic effects are not fully clarified. Activation of GLP-1 receptors in peripheral vagal neurons (6, 7) seems to be involved, suggesting that dysfunction of the vagal nerve may affect the body weight-reducing effect of liraglutide in patients. If this is the case, a substantial subset of people with diabetes may experience a reduced effect of treatment as autonomic neuropathy is a common complication to diabetes. Prevalence rates of cardiovascular autonomic neuropathy (CAN) in people with type 1 diabetes and type 2 diabetes, respectively, range from 20% in unselected diabetes populations (8, 9) to 65% in patients with long-standing diabetes(10). We hypothesize that autonomic dysfunction might be expected to influence the efficacy of GLP-1RAs in type 1 patients. Here, we explored the possible association between CAN me...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research