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The effect of liraglutide on microvascular complications and cardiovascular risk in patients with type 2 diabetes
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Sivaraman, Subash C. (2014) The effect of liraglutide on microvascular complications and cardiovascular risk in patients with type 2 diabetes. MD thesis, University of Warwick.
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WRAP_THESIS_Sivaraman_2014.pdf - Submitted Version - Requires a PDF viewer. Download (1608Kb) | Preview |
Official URL: http://webcat.warwick.ac.uk/record=b2751082~S1
Abstract
Diabetes is a chronic metabolic disease that leads to vasculopathy involving the small and large blood vessels. Studies on animal models indicate that, GLP-1 analogues might have beneficial effects on the above mentioned complications over and above the improvements due to glycaemic control. The aims of this study were to explore effects of the GLP-1 analogue, liraglutide on the microvascular complications and cardiovascular risk in human subjects with diabetes.
In a retrospective cohort study, I compared a group of patients who received liraglutide with a matched group of subjects with type 2 diabetes on other treatments. The changes in urinary albumin:creatinine ratios and retinopathy grades of these patients were compared after 12 months. In a prospective study, the serum biomarkers of diabetic nephropathy and diabetic retinopathy were measured in a group of subjects with type 2 diabetes, before and 3 months after treatment with liraglutide. In addition body composition analysis of a group of morbidly obese patients with type 2 diabetes was performed before, and 3 months after treatment with liraglutide.
In subjects with established microalbuminuria, treatment with liraglutide for 12 months did not have any effect on albumin excretion rate. Similarly, no changes in urinary albumin:creatinine ratios were evident in normoalbuminuric subjects after 12 months of treatment with liraglutide. I did not find any significant changes in the biomarkers of diabetic nephropathy following treatment with liraglutide.
In patients with type 2 diabetes, therapy with liraglutide for 12 months did not influence the course of diabetic retinopathy. No changes in the serum concentrations of VEGF (which is a biomarker for retinopathy) were noted in patients after treatment with liraglutide.
In morbidly obese subjects with type 2 diabetes, 3 months of treatment with liraglutide induced significant improvements in the markers of cardiovascular risk and reduced total body fat mass. An improvement in the mean insulin sensitivity was noted after treatment; however this did not reach statistical significance.
In conclusion, my study has shown that treatment of patients with type 2 diabetes and obesity with liraglutide was associated with improvements in markers of cardiovascular risk; but no changes in diabetic renal disease or diabetic retinopathy were evident.
Item Type: | Thesis (MD) | ||||
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Subjects: | R Medicine > RC Internal medicine | ||||
Library of Congress Subject Headings (LCSH): | Non-insulin-dependent diabetes -- Complications, Microcirculation disorders -- Prevention, Cardiovascular system -- Diseases -- Prevention | ||||
Official Date: | March 2014 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | MD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Randeva, Harpal S. | ||||
Extent: | 209 leaves : illustrations, charts | ||||
Language: | eng |
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