FASTING C-PEPTIDE INDEX MAY BE THE STRONGEST PREDICTOR FOR DETECTING EFFECTIVENESS OF GLYCEMIC CONTROL BY GLP-1 ANALOGUE, LIRAGLUTIDE THERAPY FOR JAPANESE TYPE 2 DIABETIC PATIENTS

Liraglutide (Victoza, Novo Nordisk Pharma Ltd.), a GLP-1 analogue preparation for diabetes mellitus has been reported to potently reduce the blood sugar level and decrease the body weight when injected once a day. As the risk of hypoglycemia is low, it has been used as an epoch-making drug in a rapidly increasing number of patients. In this study, we investigated the effects of liraglutide subcutaneously injected once a day in 48 patients with type 2 diabetes who had been treated at the outpatient clinic of the Diabetes Center in Yokohama Rosai hospital without admission. After 3 - month administration, the mean HbA1c value was significantly decreased (from 8.61 to 8.04%), and the mean body weight was also significantly reduced (from 71.0 to 69.2 kg). However, there were marked individual differences in the effects. We compared background factors between groups with and without improvement. The results showed that liraglutide was particularly effective in patients with a short duration of diabetes in whom endogenous insulin secretion, which was evaluated by examining fasting C-peptide with fasting sugar level, was well maintained. Furthermore, we examined the characteristics of eating behavior before and after administration using a questionnaire. In patients with a significant decrease in the blood sugar level, there was a marked improvement in the eating behavior pattern. Therefore, not only a decrease in the blood sugar level related to improved ability of endogenous insulin secretion but also the improvement of a patient's eating behavior was closely associated with a decrease in the blood sugar level after liraglutide administration.