PMID- 36923548
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230316
IS  - 1078-4497 (Print)
IS  - 1945-337X (Electronic)
IS  - 1078-4497 (Linking)
VI  - 39
IP  - Suppl 5
DP  - 2022 Nov
TI  - Assessment of Glucagon-like Peptide-1 Receptor Agonists in Veterans Taking 
      Basal/Bolus Insulin Regimens.
PG  - S18-S23
LID - 10.12788/fp.0317 [doi]
AB  - BACKGROUND: Clinical use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) 
      is well established as add-on therapy to oral medications and basal insulin. 
      However, there is little published data regarding the use of GLP-1 RAs for longer 
      than 12 months in patients taking basal/bolus insulin regimens. The primary goal 
      of our study was to assess the long-term efficacy of GLP-1 RAs as add-on therapy 
      to basal/bolus insulin regimens. METHODS: This study was a retrospective record 
      review of all patients on basal/bolus insulin regimens who received additional 
      therapy with a GLP-1 RA. The primary outcome was the change in glycosylated 
      hemoglobin A(1c) (HbA(1c)) at 3, 6, 12, 18, and 24 months after initiation of the 
      GLP-1 RA. Secondary outcomes included change in weight and total daily dose (TDD) 
      of insulin and incidence of hypoglycemia and other adverse effects (AEs). 
      RESULTS: Ninety-two patient records were reviewed. Mean glycemic control changed 
      from baseline -1.1% (95% CI, -1.3 to -0.8; P < .001) at 3 months; -1.0% (95% CI, 
      -1.3 to -0.7; P < .001) at 6 months; -0.9% (95% CI, 1.3 to -0.6; P < .001) at 12 
      months; -0.9% (95% CI, -1.4 to -0.3; P = .002) at 18 months; and -0.7 (95% CI, 
      -1.4 to 0.1; P = .07) at 24 months. A significant decrease in weight was also 
      observed from baseline through 18 months, and a significant decrease in TDD of 
      insulin was identified from baseline through 12 months. Hypoglycemia was 
      documented in 29.8% of patients at any point during GLP-1 RA therapy, and 
      gastrointestinal AEs were documented in 18.3% of patients. CONCLUSIONS: Adding 
      GLP-1 RAs to complex insulin regimens may help achieve glycemic control while 
      decreasing insulin requirements and mitigating undesirable AEs, such as weight 
      gain.
CI  - Copyright (c) 2022 Frontline Medical Communications Inc., Parsippany, NJ, USA.
FAU - Castek, Shannon L
AU  - Castek SL
AD  - Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
FAU - Healey, Lindsey C
AU  - Healey LC
AD  - Veteran Health Indiana, Indianapolis.
FAU - Kania, Deanna S
AU  - Kania DS
AD  - Veteran Health Indiana, Indianapolis.
AD  - Purdue University College of Pharmacy, West Lafayette, Indiana.
FAU - Vernon, Veronica P
AU  - Vernon VP
AD  - Veteran Health Indiana, Indianapolis.
AD  - Butler University College of Pharmacy and Health Sciences, Indianapolis.
FAU - Dawson, Andrea J
AU  - Dawson AJ
AD  - Veteran Health Indiana, Indianapolis.
LA  - eng
PT  - Journal Article
DEP - 20220926
PL  - United States
TA  - Fed Pract
JT  - Federal practitioner : for the health care professionals of the VA, DoD, and PHS
JID - 9500574
PMC - PMC10010496
COIS- Author disclosures The authors report no actual or potential conflicts of 
      interest or outside sources of funding with regard to this article.
EDAT- 2023/03/17 06:00
MHDA- 2023/03/17 06:01
PMCR- 2022/11/01
CRDT- 2023/03/16 02:25
PHST- 2023/03/16 02:25 [entrez]
PHST- 2023/03/17 06:00 [pubmed]
PHST- 2023/03/17 06:01 [medline]
PHST- 2022/11/01 00:00 [pmc-release]
AID - fp-39-11s-s18 [pii]
AID - 10.12788/fp.0317 [doi]
PST - ppublish
SO  - Fed Pract. 2022 Nov;39(Suppl 5):S18-S23. doi: 10.12788/fp.0317. Epub 2022 Sep 26.