How much weight loss occurs with Liraglutide in real
clinical use. Is weight loss durable over time?
How much HbA1c reduction occurs with Liraglutide in real
clinical use. Is this reduction durable over time in the real world?
What is the real world experience of progression to insulin
treatment in patients treated with liraglutide?
What is the impact on lipids of Liraglutide in real
What is the impact on alanine aminotransferase (ALT) of Liraglutide –
through weight loss and impact on lipids might Liraglutide improve non
alcoholic fatty liver disaease (NAFLD).
Who are the patients who respond especially well to
Liraglutide in real clinical use – does it relate to initial HbA1c,
weight, body mass index, duration of diabetes, initial age or sex, or
particular other medications being used etc. Is it possible to predict
the patients who are more likely to respond to Liraglutide.
Similarly, who are the patients who don’t respond to
Currently Liraglutide usage with insulin is off license
but, as with exenatide, it is likely that some diabetologists may try it
with insulin, in certain particular difficult clinical situations, where
such a usage seems to be best for the patient. The nationwide audit
affords an opportunity to pool experience of usage of Liraglutide with
insulin across the nation, find out how useful this approach is, the
extent to which control is improved, insulin dose is reduced or insulin
is even stopped. The data may help bring forward the licensing of usage
of Liraglutide with insulin, if the combination does prove to be a good
What are the side effects? The possibility of thyroid
problems and pancreatitis have both been considered in relation to
Liraglutide usage but neither seem to have come through as causes for
concern in the phase 3 clinical trials. Nevertheless worries continue in
the minds of many clinicians who will feel reassured that there is a
robust reporting system for adverse events in place through the audit.
The audit provides a vehicle for further reassurance with regard to
these side effects to compliment the phase 3 trials. Are there any
important side effects that have not yet been identified?
there are safety issues with Liraglutide which may come
out in due course, we hope to get some forewarning of these now through
pooling the national experience.
what extent does Liraglutide allow avoidance of insulin and continuation
in their jobs for professional drivers, or regaining of
their jobs for such workers who have lost them through insulin?
What is the size of the problem of hypoglycaemia with
Liraglutide and insulin, or Liraglutide and sulphonylureas. Is there a
problem of worsening hyperglycaemia if insulin is stopped and
Liraglutide started? Are there guidelines that can be deduced from the
nationwide expereience with regard to how to add Liraglutide to insulin
and how to add Liraglutide to sulphonylureas without inducing
hypoglycaemia or hyperglycaemia.
What percentage of patients cannot tolerate Liraglutide in
real clinical use?
the clinical efficacy of Liraglutide sustained in real clinical use?
Does the weight loss continue with time or does it plateau off?
Are there benefits, or otherwise, in combining thiazolidinediones
Could we, from the data, calculate the potential benefit in terms of
predicting cardiovascular event reduction on the as yet
unvalidated assumption that the reduction in risk factors is translated
into prevention of cardiovascular events?