Date of Award
Background: Diabetes mellitus is a metabolic disorder defined by high blood glucose. Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a newer class of medications that offer potential 2 to 3 kg weight loss and a 1% to 1.5% decrease in A1c. At the Indianapolis Veterans Affairs Medical Center (VAMC), GLP-1-RAs are non-formulary.
Objectives: Primary outcomes included mean change in weight, body mass index (BMI) and A1c in VAMC patients. Secondary outcomes included the comparison to published values, analysis of insulin needs, and analysis of GLP-1-RA discontinuation reasons.
Methods: Indianapolis VAMC patients ages 18-80 with type 2 diabetes who started a GLP-1-RA from January 1, 2010 to July 1, 2016 were identified. The following data points were gathered at monthly intervals before spreading out to biannual: specific GLP1-RA and dose; weight; BMI; A1c; other diabetes medications; insulin requirements; and any reason for discontinuation. This report is an analysis of the baseline, 24 week, and 48 week data.
Results: With a mean age of 62.2 years and a 90.2% male population, the cohort decreased their weight from baseline by 2.5 kg at 24 weeks of use and 3.6 kg at 48 weeks. A1c decreased by 1.3% in the first 24 weeks and was maintained at 48 weeks. Insulin use decreased during the study. Seven percent of patients discontinued GLP-1- RAs due to GI intolerance.
Conclusion: GLP-1-RAs have a similar effect on weight and A1c in the veteran population compared to previous study populations. Based on this and further research, GLP-1-RA use may be expanded in the future.
Beutel Darrow, Shelby L., "A1c Reduction and Weight Loss in a Veteran Population Using GLP-1-RAs" (2017). Undergraduate Honors Thesis Collection. 422.