Skip to main content
Top
Published in: Sleep and Breathing 5/2023

Open Access 21-12-2022 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Original Article

Efficacy and safety of liraglutide in patients with type 2 diabetes mellitus and severe obstructive sleep apnea

Authors: Wenlong Jiang, Weiguo Li, Jing Cheng, Wen Li, Fangzhou Cheng

Published in: Sleep and Breathing | Issue 5/2023

Login to get access

Abstract

Objectives

To observe the efficacy and side effects of liraglutide in the treatment of type 2 diabetes mellitus (T2DM) patients with severe obstructive sleep apnea (OSA).

Methods

The study conducted in an outpatient setting was a two-center, prospective randomized controlled study. T2DM patients with severe OSA were randomized to the control group (continuous positive airway pressure [CPAP] and drug treatment without liraglutide) or the liraglutide group (CPAP and drug treatment including liraglutide). Demographic and clinical characteristics, sleep-disordered breathing indices, cardiac function indices, and side effects were evaluated and compared between the two groups before and after 3 months.

Results

Of 90 patients, 45 were randomized to the intervention arm (with liraglutide) and 45 to the control arm (without liraglutide). One patient in the liraglutide group dropped out of the study on day 8 after enrollment due to obvious gastrointestinal symptoms. No significant differences were found between the two groups in baseline demographics, clinical characteristics, cardiac function indicators, or sleep disorder respiratory indices (P > 0.05). After 3 months, the body mass index (BMI), apnea hypopnea index (AHI), and mean systolic blood pressure in the liraglutide treatment group were significantly lower than those in the control group (P < 0.05). The minimum oxygen saturation was significantly higher in the liraglutide group compared with that in the control group after 3 months of follow-up (P < 0.05). No difference was found between the two groups in the summary of side effects (P > 0.05).

Conclusions

Liraglutide combined with CPAP can effectively reduce BMI, lower mean systolic blood pressure, and improve AHI scores and hypoxia in T2DM patients with severe OSA. Liraglutide did not increase side effects.
Literature
1.
go back to reference Devaraj NK (2020) Knowledge, attitude, and practice regarding obstructive sleep apnea among primary care physicians. Sleep and Breathing 24(4):1581–1590CrossRefPubMed Devaraj NK (2020) Knowledge, attitude, and practice regarding obstructive sleep apnea among primary care physicians. Sleep and Breathing 24(4):1581–1590CrossRefPubMed
2.
go back to reference Coughlin SR, Mawdsley L, Mugarza JA et al (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25:735–741CrossRefPubMed Coughlin SR, Mawdsley L, Mugarza JA et al (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25:735–741CrossRefPubMed
5.
go back to reference Huang T, Lin BM, Stampfer MJ et al (2018) A population-based study of the bidirectional association between obstructive sleep apnea and type 2 diabetes in three prospective US cohorts. Diabetes Care 41:2111–9CrossRefPubMedPubMedCentral Huang T, Lin BM, Stampfer MJ et al (2018) A population-based study of the bidirectional association between obstructive sleep apnea and type 2 diabetes in three prospective US cohorts. Diabetes Care 41:2111–9CrossRefPubMedPubMedCentral
6.
go back to reference Giles TL, Lasserson TJ, Smith BH et al (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev CD001106 Giles TL, Lasserson TJ, Smith BH et al (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev CD001106
7.
go back to reference Foster GD, Borradaile KE, Sanders MH et al (2009) A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the sleep ahead study. Arch Intern Med 169:1619–1626CrossRefPubMedPubMedCentral Foster GD, Borradaile KE, Sanders MH et al (2009) A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the sleep ahead study. Arch Intern Med 169:1619–1626CrossRefPubMedPubMedCentral
8.
go back to reference Ashrafian H, le Roux CW, Rowland SP et al (2012) Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax 67:442–449CrossRefPubMed Ashrafian H, le Roux CW, Rowland SP et al (2012) Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax 67:442–449CrossRefPubMed
9.
go back to reference Craig SE, Kohler M, Nicoll D et al (2012) Continuous positive airway pressure improves sleepiness but not calculated vascular risk in patients with minimally symptomatic obstructive sleep apnoea: the mosaic randomised controlled trial. Thorax 67:1090–1096CrossRefPubMed Craig SE, Kohler M, Nicoll D et al (2012) Continuous positive airway pressure improves sleepiness but not calculated vascular risk in patients with minimally symptomatic obstructive sleep apnoea: the mosaic randomised controlled trial. Thorax 67:1090–1096CrossRefPubMed
10.
go back to reference Drager LF, Brunoni AR, Jenner R et al (2015) Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials. Thorax 70:258–264CrossRefPubMed Drager LF, Brunoni AR, Jenner R et al (2015) Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials. Thorax 70:258–264CrossRefPubMed
11.
go back to reference Food and Drug Administration. Prescribing information for Saxenda, 2018 [Internet]. Maryland: Food and Drug Administration; 2018 [cited 2020 May 29] Food and Drug Administration. Prescribing information for Saxenda, 2018 [Internet]. Maryland: Food and Drug Administration; 2018 [cited 2020 May 29]
12.
go back to reference Buse JB, Nauck M, Forst T et al (2013) Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6): a randomised, open-label study. Lancet 381(9861):117–124CrossRefPubMed Buse JB, Nauck M, Forst T et al (2013) Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6): a randomised, open-label study. Lancet 381(9861):117–124CrossRefPubMed
13.
go back to reference Secher A, Jelsing J, Baquero AF et al (2014) The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. J Clin Invest 124(10):4473–4488CrossRefPubMedPubMedCentral Secher A, Jelsing J, Baquero AF et al (2014) The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. J Clin Invest 124(10):4473–4488CrossRefPubMedPubMedCentral
15.
go back to reference Williams DL, Baskin DG, Schwartz MW (2009) Evidence that intestinal glucagon-like peptide-1 plays a physiological role in satiety. Endocrinology 150(4):1680–1687CrossRefPubMed Williams DL, Baskin DG, Schwartz MW (2009) Evidence that intestinal glucagon-like peptide-1 plays a physiological role in satiety. Endocrinology 150(4):1680–1687CrossRefPubMed
16.
go back to reference Wing RR, Lang W, Wadden TA et al (2011) Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 34(7):1481–1486CrossRefPubMedPubMedCentral Wing RR, Lang W, Wadden TA et al (2011) Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 34(7):1481–1486CrossRefPubMedPubMedCentral
17.
go back to reference Collier A, Blackman A, Foster G et al (2014) S28 liraglutide 3.0 mg reduces severity of obstructive sleep apnoea and body weight in obese individuals with moderate or severe disease: Scale Sleep Apnoea Trial. BMJ Publishing Group Ltd Collier A, Blackman A, Foster G et al (2014) S28 liraglutide 3.0 mg reduces severity of obstructive sleep apnoea and body weight in obese individuals with moderate or severe disease: Scale Sleep Apnoea Trial. BMJ Publishing Group Ltd
18.
go back to reference Patinkin ZW, Feinn R, Santos M (2017) Metabolic consequences of obstructive sleep apnea in adolescents with obesity: a systematic literature review and meta-analysis. Child Obes 13(2):102–110CrossRefPubMed Patinkin ZW, Feinn R, Santos M (2017) Metabolic consequences of obstructive sleep apnea in adolescents with obesity: a systematic literature review and meta-analysis. Child Obes 13(2):102–110CrossRefPubMed
19.
go back to reference Khan MA, Mathur K, Barraza G et al (2020) The relationship of hypertension with obesity and obstructive sleep apnea in adolescents. Pediatr Pulmonol 55(4):1020–1027CrossRefPubMed Khan MA, Mathur K, Barraza G et al (2020) The relationship of hypertension with obesity and obstructive sleep apnea in adolescents. Pediatr Pulmonol 55(4):1020–1027CrossRefPubMed
20.
go back to reference Pelaia C, Armentaro G, Miceli S et al (2021) Association between sleep apnea and valvular heart diseases. Front Med (Lausanne) 9(8):667522CrossRef Pelaia C, Armentaro G, Miceli S et al (2021) Association between sleep apnea and valvular heart diseases. Front Med (Lausanne) 9(8):667522CrossRef
21.
go back to reference Rezaie L, Maazinezhad S, Fogelberg DJ, Khazaie H, Sadeghi-Bahmani D, Brand S (2021) Compared to individuals with mild to moderate obstructive sleep apnea (OSA), individuals with severe OSA had higher BMI and respiratory-disturbance scores. Life (Basel) 11(5):368PubMed Rezaie L, Maazinezhad S, Fogelberg DJ, Khazaie H, Sadeghi-Bahmani D, Brand S (2021) Compared to individuals with mild to moderate obstructive sleep apnea (OSA), individuals with severe OSA had higher BMI and respiratory-disturbance scores. Life (Basel) 11(5):368PubMed
22.
go back to reference Hall KA, Singh M, Mukherjee S, Palmer LJ (2020) Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. J Clin Sleep Med 16:1179–2118CrossRefPubMedPubMedCentral Hall KA, Singh M, Mukherjee S, Palmer LJ (2020) Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. J Clin Sleep Med 16:1179–2118CrossRefPubMedPubMedCentral
23.
go back to reference Urbanik D, Martynowicz H, Mazur G et al (2020) Environmental factors as modulators of the relationship between obstructive sleep apnea and lesions in the circulatory system. J Clin Med 9:836CrossRefPubMedPubMedCentral Urbanik D, Martynowicz H, Mazur G et al (2020) Environmental factors as modulators of the relationship between obstructive sleep apnea and lesions in the circulatory system. J Clin Med 9:836CrossRefPubMedPubMedCentral
24.
go back to reference Tietjens JR, Claman D, Kezirian EJ, Yeghiazarians Y et al (2019) Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. J Am Heart Assoc 8:e010440CrossRefPubMed Tietjens JR, Claman D, Kezirian EJ, Yeghiazarians Y et al (2019) Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. J Am Heart Assoc 8:e010440CrossRefPubMed
25.
go back to reference Labarca G, Dreyse J, Drake L, Jorquera J, Barbe F (2020) Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: systematic review and meta-analysis. Sleep Med Rev 52:101312CrossRefPubMed Labarca G, Dreyse J, Drake L, Jorquera J, Barbe F (2020) Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: systematic review and meta-analysis. Sleep Med Rev 52:101312CrossRefPubMed
26.
go back to reference Rezaie L, Phillips D, Khazaie H (2018) Barriers to acceptance and adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea: a report from Kermanshah province, western Iran. Patient Prefer Adherence 12:1299–1304CrossRefPubMedPubMedCentral Rezaie L, Phillips D, Khazaie H (2018) Barriers to acceptance and adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea: a report from Kermanshah province, western Iran. Patient Prefer Adherence 12:1299–1304CrossRefPubMedPubMedCentral
27.
go back to reference Pi-Sunyer X, Astrup A, Fujioka K et al (2015) A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 373(1):11–22CrossRefPubMed Pi-Sunyer X, Astrup A, Fujioka K et al (2015) A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 373(1):11–22CrossRefPubMed
28.
go back to reference Buse JB, Rosenstock J, Sesti G et al (2009) Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet 374(9683):39–47CrossRefPubMed Buse JB, Rosenstock J, Sesti G et al (2009) Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet 374(9683):39–47CrossRefPubMed
Metadata
Title
Efficacy and safety of liraglutide in patients with type 2 diabetes mellitus and severe obstructive sleep apnea
Authors
Wenlong Jiang
Weiguo Li
Jing Cheng
Wen Li
Fangzhou Cheng
Publication date
21-12-2022
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 5/2023
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-022-02768-y

Other articles of this Issue 5/2023

Sleep and Breathing 5/2023 Go to the issue

Sleep Breathing Physiology and Disorders • Original Article

Contribution of central sleep apnea to severe sleep apnea hypopnea syndrome