Glycemia and Gluconeogenesis With Metformin and Liraglutide: A Randomized Trial in Youth-onset Type 2 Diabetes
Authors' conclusion
Among Y-T2D, metformin with or without liraglutide improved glycemia but did not suppress high rates of gluconeogenesis. Novel therapies that will enhance β-cell function and target the elevated rates of gluconeogenesis in Y-T2D are needed.
Study context
- Population
- African American youth with youth-onset T2D; age 15.3 ± 2.1 years (mean ± SD), 68% female, body mass index (BMI) 40.1 ± 7.9 kg/m², duration of diagnosis 1.8 ± 1.3 years
- Participants
- 22 participants
- Comparison
- Metformin + liraglutide vs metformin alone
Methodological detailsparallel
- Parallel
Primary result
As reported in the abstract
Change from baseline in fasting glucose · 12 weeks
Met + liraglutide (Lira)
−2.0
mean · SD 1.3 · mmol/L
Met
−0.6
mean · SD 0.9 · mmol/L
P = 0.008
Further findings
| Outcome | Met + Lira | Met | P value |
|---|---|---|---|
| Change in β-cell function (sigma) · 12 weeksGreater increase with Met + Lira · mean | 0.72 (SD 0.68) | −0.05 (SD 0.71) | P = 0.03 |
| Change in fractional gluconeogenesis · 12 weeksSimilar between groups · mean, % | −0.36 (SD 9.4) | 0.04 (SD 12.3) | P = 0.9 |
Prandial gluconeogenesis and mSI · 12 weeks
- No changes in prandial gluconeogenesis or mSI
Increased glucose clearance (both groups) vs sigma
- Correlation with sigma (not gluconeogenesis or mSI)
- r = 0.63, P = .003
Baseline characteristics
- Gluconeogenesis, glucose production, fasting and 2-hour glucose comparable; higher HbA1c with Met + Lira
Original publication
Glycemia and Gluconeogenesis With Metformin and Liraglutide: A Randomized Trial in Youth-onset Type 2 Diabetes. J Clin Endocrinol Metab. Published 15 November 2023. doi:10.
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