Background NICE guidelines recommend the use of Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RA) for adults with type-2 diabetes who have a BMI of 35 kg/m2 or higher, and continue therapy if a reduction of at least 1% in HbA1c and a weight loss of at least 3% in 6 months is achieved.
Purpose To describe if the prescriptions of GLP-1 RA are in accordance with NICE type-2 diabetes guidance, assessing the effectiveness of GLP-1 RA, in terms of HbA1c reduction and weight loss.
Material and methods Observational, retrospective study in patients treated with GLP-1 RA for at least 6 months during 2015 in a community health centre. The source of anonymous data was a computer application for clinical data consulting (Consult@web). Collected variables were: age, sex, drug, duration of treatment, and Hb1Ac, BMI and weight at baseline and 6 moths of treatment. Statistical analysis was performed using Student’s test for differences between effectiveness variables.
Results Seventy-one patients were included in the study, average age 60.9 years (range 39.1–85.6). The average BMI of 66 evaluable patients was 37.4±5.7 kg/m2 and the average weight was 100.6±16.4 kg.
Mean Hb1Ac at baseline and 6 months of treatment was 8.4 (95% CI: 8 to 8.9) and 7.3 (95% CI: 7 to 7.7) respectively (p=0.173). Thirty-six of 62 evaluable patients (58%) achieved a 1% reduction in Hb1Ac. According to NICE guidance 27% (17/62) of patients met the criteria to continue therapy after 6 months.
Weight values at baseline and 6 months of treatment were 100.6 (95% CI: 96.3 to 105.5) and 97.0 (95% CI: 92.8 to 101.7) respectively (p<0.0001). Weight change could be assessed in 48 patients, and 70.83% of them reached the target of 3% wt loss. According to NICE guidance, only 52% (25/48) met the criteria to continue therapy after 6 months.
Conclusion GLP-1 RA therapy reduced Hb1Ac, but differences were not significant. Significant differences were found in weight loss. The prescriptions’ compliance in accordance with the NICE guidance was low because many patients continued treatment despite not achieving the expected effectiveness.
References and/or Acknowledgements NICE guidance.
No conflict of interest
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