Weight loss maintenance with exercise and liraglutide improves glucose tolerance, glucagon response, and beta cell function

Simon B K Jensen, Christian R Juhl, Charlotte Janus, Julie R Lundgren, Christoffer Martinussen, Christoffer Wiingaard, Cecilie Knudsen, Ruth Frikke-Schmidt, Bente M Stallknecht, Jens J Holst, Sten Madsbad, Signe S Torekov*

*Corresponding author for this work

Abstract

OBJECTIVE: The aim of this study was to investigate glucose tolerance, glucagon response, and beta cell function during a 1-year maintenance period with either exercise, the glucagon-like peptide-1 receptor agonist liraglutide, or the combination after diet-induced weight loss.

METHODS: In this randomized placebo-controlled trial, adults with obesity (BMI: 32-43 kg/m2 ) without diabetes underwent an 8-week low-calorie diet (800 kcal/d) and were randomized to 52 weeks of aerobic exercise, liraglutide 3.0 mg/d, exercise and liraglutide combined, or placebo. Change in glucose and glucagon response to a 3-hour mixed meal test and disposition index, as a measure of beta cell function, were measured.

RESULTS: A total of 195 participants were randomized. After 1 year of treatment, the combination group had decreased postprandial glucose response by -9% (95% CI: -14% to -3%; p = 0.002), improved beta cell function by 49% (95% CI: 16% to 93%; p = 0.002), and decreased glucagon response by -18% (95% CI: -34% to -3%; p = 0.024) compared with placebo. Compared with placebo, liraglutide alone improved postprandial glucose response by -7% (95% CI: -12% to -1%; p = 0.018), but not beta cell function or glucagon. Exercise alone had similar postprandial glucose response, beta cell function, and glucagon response as placebo.

CONCLUSIONS: Only the combination of exercise and liraglutide improved glucose tolerance, beta cell function, and glucagon responses after weight loss.

Original languageEnglish
JournalObesity (Silver Spring, Md.)
Volume31
Issue number4
Pages (from-to)977-989
Number of pages13
ISSN1930-7381
DOIs
Publication statusPublished - Apr 2023

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