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Efficacy and safety of the glucagon-like peptide-1 receptor agonist liraglutide added to insulin therapy in poorly regulated patients with type 1 diabetes—a protocol for a randomised, double-blind, placebo-controlled study: The Lira-1 study
  1. Thomas Fremming Dejgaard1,2,
  2. Filip Krag Knop3,4,
  3. Lise Tarnow5,
  4. Christian Seerup Frandsen2,
  5. Tanja Stenbæk Hansen1,
  6. Thomas Almdal3,
  7. Jens Juul Holst4,
  8. Sten Madsbad2,
  9. Henrik Ullits Andersen1
  1. 1Steno Diabetes Center, Gentofte, Denmark
  2. 2Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
  3. 3Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
  4. 4Faculty of Health and Medical Sciences, Department of Biomedical Sciences, The NNF Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
  5. 5Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark
  1. Correspondence to Thomas Fremming Dejgaard; tfde{at}steno.dk

Abstract

Introduction Intensive insulin therapy is recommended for the treatment of type 1 diabetes (T1D). Hypoglycaemia and weight gain are the common side effects of insulin treatment and may reduce compliance. In patients with insulin-treated type 2 diabetes, the addition of glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy has proven effective in reducing weight gain and insulin dose. The present publication describes a protocol for a study evaluating the efficacy and safety of adding a GLP-1RA to insulin treatment in overweight patients with T1D in a randomised, double-blinded, controlled design.

Methods and analysis In total, 100 patients with type 1 diabetes, poor glycaemic control (glycated haemoglobin (HbA1c) >8%) and overweight (body mass index >25 kg/m2) will be randomised to either liraglutide 1.8 mg once daily or placebo as an add-on to intensive insulin therapy in this investigator initiated, double-blinded, placebo-controlled parallel study. The primary end point is glycaemic control as measured by changes in HbA1c. Secondary end points include changes in the insulin dose, hypoglyacemic events, body weight, lean body mass, fat mass, food preferences and adverse events. Glycaemic excursions, postprandial glucagon levels and gastric emptying rate during a standardised liquid meal test will also be studied.

Ethics and dissemination The study is approved by the Danish Medicines Authority, the Regional Scientific-Ethical Committee of the Capital Region of Denmark and the Data Protection Agency. The study will be carried out under the surveillance and guidance of the good clinical practice (GCP) unit at Copenhagen University Hospital Bispebjerg in accordance with the ICH-GCP guidelines and the Helsinki Declaration.

Trial registration number NCT01612468.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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