New approach to reducing diabetes risk

An international clinical trial conducted by the University of Liverpool has shown that the drug liraglutide 3.0 mg may reduce diabetes risk by 80% in individuals with obesity and pre-diabetes according to a study published in The Lancet (University of Liverpool, 2017).

The three year SCALE obesity and pre-diabetes trial followed 2,254 adults with pre-diabetes at 191 research sites in 27 countries worldwide. The aim was to evaluate whether liraglutide 3.0 mg can safely delay the onset of type 2 diabetes in participants with pre-diabetes.

Pre-diabetes, also commonly referred to as borderline diabetes, is a metabolic condition and growing global problem that is closely tied to obesity. In the UK one in ten people have pre-diabetes. The associated health care cost to the economy is significant. These individuals are at risk of a range of conditions that can affect their overall health including type 2 diabetes and its complications as well as cardiovascular disease and cancer.

Liraglutide promotes weight loss by interacting with the areas of the brain that control appetite and energy intake. The participants in the study, which was conducted at University Hospital Aintree, were randomly allocated to either liraglutide 3.0 mg or a placebo delivered by injection under the skin once daily for one hundred and sixty weeks. They were also placed on a reduced calorie diet and advised to increase their physical activity.

The study showed that three years of continuous treatment with once daily liraglutide 3.0 mg, in combination with diet and increased physical activity, reduces the risk of developing type 2 diabetes by 80% and results in greater sustained weight loss compared to the placebo.

Professor John Wilding, Professor of Medicine at the University of Liverpool’s Institute of Ageing and Chronic Disease and Honorary Consultant Physician is an obesity specialist was an investigator in the trial and an author of this study. He said “In this study, we wanted to see if this drug in combination with a reduced-calorie diet and lifestyle intervention could delay the onset of type 2 diabetes in a high-risk population with obesity and prediabetes. On the basis of our findings, liraglutide 3.0 mg can provide us with a new therapeutic approach for patients with obesity and prediabetes to substantially reduce their risk of developing type 2 diabetes and its related complications. As healthcare professionals, it is important that we can offer a treatment to our type 2 diabetes patients that we are confident will achieve results in the real-world that are consistent with the results of the clinical trial programme.”

The study is a continuation of work started by John Wilding in 1996 when he was working at the Hammersmith Hospital in London, and was part of the team that first showed that the hormone GLP-1, on which liraglutide is based, was involved in the control of food intake. He said “It is very exciting to see a laboratory observation translated into a medicine that has the potential to help so many people, even though it has taken over 20 years.”

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