High-Dose Liraglutide and SGLT2 Inhibitor: A Promising Combination.
Marvin Wei Jie ChuaPublished in: Clinics and practice (2021)
Sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists are important drugs in our armamentarium of treatment for Type 2 diabetes mellitus (DM). In addition to their glucose-lowering effects, they have effects on weight, other metabolic diseases and perhaps most importantly, a cardioprotective and reno-protective effect. Liraglutide is a long-acting GLP-1 agonist which was originally used at 1.8 mg daily for the treatment of DM. However, high-dose liraglutide-liraglutide 3 mg daily, has been demonstrated to be a safe and effective treatment for obesity, with or without DM. In this manuscript, I present two patients who had unusual responses to combination therapy with high-dose liraglutide and SGLT2 inhibitor-marked and/or rapid improvement in glycemic control and weight loss. Drawing from the observations in both cases, I discuss the complementary mechanisms of actions of both drugs, review the clinical effects of combination therapy and distil them into clinical pearls of practical utility for the physician. Given the "clash of the two pandemics" of obesity and COVID-19 and the burgeoning rates of obesity which loom in the near horizon, this is most timely.
Keyphrases
- combination therapy
- weight loss
- glycemic control
- high dose
- type diabetes
- bariatric surgery
- insulin resistance
- metabolic syndrome
- low dose
- blood glucose
- weight gain
- roux en y gastric bypass
- physical activity
- primary care
- gastric bypass
- emergency department
- high fat diet induced
- body mass index
- sars cov
- blood pressure
- replacement therapy
- cardiovascular disease