GLP-1 agonists are commonly prescribed for the treatment of T2DM with obesity, but have also shown efficacy in obesity alone. We conducted a retrospective study to examine the efficacy of liraglutide (Saxenda, Victoza) and dulaglutide (Trulicity). We examined weight change, duration of use, prescribed dose, tolerability and whether lifestyle changes were implemented. Results were analysed for combined GLP-1 agonist use, and liraglutide and dulaglutide alone using ANOVA and shown as mean + SEM.
143 patients were prescribed GLP-1 agonists (75% liraglutide, 25% dulaglutide). 64.3% were female, 54.6% had a diagnosis of diabetes and 77.6% were co-prescribed metformin. Liraglutide users were asked to stay on the maximum tolerated dose for as long as possible. Doses were 0.6mg (22%), 1.2mg (37%), 1.8mg (17%), 2.4mg (7%) and 3.0mg (17%). Dulaglutide users received fixed dose 1.5mg weekly. 83.8% of all GLP-1 agonists users experienced reduced appetite while 30.3% reported adverse side effects. Dulaglutide users had less side effects than liraglutide users (8.3%vs37.4%). 63.1% modified their diet, while 17.7% increased exercise. The mean weight loss of patients using dulaglutide was greater than those using liraglutide (6.13kg+0.45 vs. 4.87kg+0.56) over a mean of 5.03+0.29 months compared to 4.89+0.49 months respectively. Patients who used GLP-1 agonists for longer had greater reduction in weight (p=0.003). In such patients, the addition of metformin(p=0.009), appetite reduction (p=0.004) and absence of adverse side effects (p=0.002) were associated with greater weight loss. Diet modification was also associated with increased weight loss however increased exercise was not.
We recommend liraglutide be used at lower doses to improve patient compliance, treatment duration and efficacy.