Liraglutide, Sitagliptin, and Insulin Glargine Added to Metformin in Patients With Type 2 Diabetes

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WHO:

Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.

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TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.

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Payment will be processed through an online secure transaction portal. The fees for consultative services are:

Initial 60 minute consultation per patient: $500.00
Follow Up 30 minute consultation per patient: $300.00

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Liraglutide, Sitagliptin, and Insulin Glargine Added to Metformin in Patients With Type 2 Diabetes

Jul 22, 2019

Liraglutide, Sitagliptin, and Insulin Glargine Added to Metformin in Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease

ABSTRACT
To investigate the effect of antidiabetic agents on nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM), 75 patients with T2DM and NAFLD under inadequate glycemic control by metformin were randomized (1:1:1) to receive add‐on liraglutide, sitagliptin, or insulin glargine in this 26‐week trial. The primary endpoint was the change in intrahepatic lipid (IHL) from baseline to week 26 as quantified by magnetic resonance imaging–estimated proton density fat fraction (MRI‐PDFF). Secondary endpoints included changes in abdominal adiposity (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT]), glycated hemoglobin, and body weight from baseline to week 26. We analysed data from intent‐to‐treat population. MRI‐PDFF, VAT, and weight decreased significantly with liraglutide (15.4% ± 5.6% to 12.5% ± 6.4%, P < 0.001; 171.4 ± 27.8 to 150.5 ± 30.8, P = 0.003; 86.6 ± 12.9 kg to 82.9 ± 11.1 kg, P = 0.005, respectively) and sitagliptin (15.5% ± 5.6% to 11.7% ± 5.0%, P = 0.001; 153.4 ± 31.5 to 139.8 ± 27.3, P = 0.027; 88.2 ± 13.6 kg to 86.5 ± 13.2 kg, P = 0.005, respectively). No significant change in MRI‐PDFF, VAT, or body weight was observed with insulin glargine. SAT decreased significantly in the liraglutide group (239.9 ± 69.0 to 211.3 ± 76.1; P = 0.020) but not in the sitagliptin and insulin glargine groups. Changes from baseline in MRI‐PDFF, VAT, and body weight were significantly greater with liraglutide than insulin glargine but did not differ significantly between liraglutide and sitagliptin. Conclusion: Combined with metformin, both liraglutide and sitagliptin, but not insulin glargine, reduced body weight, IHL, and VAT in addition to improving glycemic control in patients with T2DM and NAFLD.

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