Efficacy and Acceptability of Glycemic Control of Glucagon-Like Peptide-1 Receptor Agonists among Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.

Li Z, Zhang Y, Quan X, Yang Z, Zeng X, Ji L, Sun F, Sun F, Zhan S

PloS one9 May 2016Cited by 28 (Europe PMC)

PMID27158818PMCIDPMC4861281DOI10.1371/journal.pone.0154206PepBankPUB-27158818

Summary

ObjectiveTo synthesize current evidence of the impact of Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on hypoglycemia, treatment discontinuation and glycemic level in patients with type 2 diabetes.DesignSystematic review and network meta-analysis.Data sourcesLiterature search (Medline, Embase, the Cochrane library), website of clinical trial, bibliographies of published systematic reviews.Eligibility criteriaRandomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.Data synthesisTraditional pairwise meta-analyses within DerSimonian-Laird random effects model and network meta-analysis within a Bayesian framework were performed to calculate odds ratios for the incidence of hypoglycemia, treatment discontinuation, HbA1c<7.0% and HbA1c<6.5%. Ranking probabilities for all treatments were estimated to obtain a treatment hierarchy using the surface under the cumulative ranking curve (SUCRA) and mean ranks.Results78 trials with 13 treatments were included. Overall, all GLP-1 RAs except for albiglutide increased the risk of hypoglycemia when compared to placebo. Reduction in the incidence of hypoglycemia was found for all GLP-1 RAs versus insulin (except for dulaglutide) and sulphonylureas. For the incidence of treatment discontinuation, increase was found for exenatide, liraglutide, lixisenatide and taspoglutide versus placebo, insulin and sitagliptin. For glycemic level, decrease was found for all GLP-1 RAs versus placebo. Dulaglutide, exenatide long-acting release (exe_lar), liraglutide and taspoglutide had significant lowering effect when compared with sitagliptin (HbA1c<7.0%) and insulin (HbA1c<6.5%). Finally, according to SUCRAs, placebo, thiazolidinediones and albiglutide had the best decrease effect on hypoglycemia; sulphanylureas, sitagliptin and insulin decrease the incidence of treatment discontinuation most; exe_lar and dulaglutide had the highest impact on glycemic level among 13 treatments.ConclusionsAmong 13 treatments, GLP-1 RAs had a significant reduction with glycemic level but a slight increase effect on hypoglycemia and treatment discontinuation. While albiglutide had the best decrease effect on hypoglycemia and treatment discontinuation among all GLP-1 RAs. However, further evidence is necessary for more conclusive inferences on mechanisms underlying the rise in hypoglycemia.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study9

5 results from studies that gave the peptide. 5 results from people.

01HumanSystematic reviewSafety outcome
In adults with type 2 diabetes, network meta-analysis found more treatment discontinuation with liraglutide than with placebo.
In plain wordsIn adults with type 2 diabetes, more people stopped treatment with liraglutide than with placebo.
Peptide
Liraglutide
Outcome
IncreaseTreatment discontinuation versus placebo
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
For the incidence of treatment discontinuation, increase was found for exenatide, liraglutide, lixisenatide and taspoglutide versus placebo, insulin and sitagliptin.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
Show in the study text Report a problemFND-2715881801
02HumanSystematic reviewSafety outcome
In adults with type 2 diabetes, network meta-analysis found more treatment discontinuation with liraglutide than with insulin.
In plain wordsIn adults with type 2 diabetes, more people stopped treatment with liraglutide than with insulin.
Peptide
Liraglutide
Outcome
IncreaseTreatment discontinuation versus insulin
Study
n: not reported in source
Comparator
Insulin
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
For the incidence of treatment discontinuation, increase was found for exenatide, liraglutide, lixisenatide and taspoglutide versus placebo, insulin and sitagliptin.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
Show in the study text Report a problemFND-2715881802
03HumanSystematic reviewSafety outcome
In adults with type 2 diabetes, network meta-analysis found more treatment discontinuation with liraglutide than with sitagliptin.
In plain wordsIn adults with type 2 diabetes, more people stopped treatment with liraglutide than with sitagliptin.
Peptide
Liraglutide
Outcome
IncreaseTreatment discontinuation versus sitagliptin
Study
n: not reported in source
Comparator
Sitagliptin
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
For the incidence of treatment discontinuation, increase was found for exenatide, liraglutide, lixisenatide and taspoglutide versus placebo, insulin and sitagliptin.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
Show in the study text Report a problemFND-2715881803
04HumanSystematic reviewEfficacy outcome
In adults with type 2 diabetes, liraglutide had a significant lowering effect on glycemic level (HbA1c<7.0%) compared with sitagliptin.
In plain wordsIn adults with type 2 diabetes, liraglutide lowered blood sugar control measures more than sitagliptin.
Peptide
Liraglutide
Outcome
DecreaseGlycemic level (HbA1c<7.0%) versus sitagliptin
Study
n: not reported in source
Comparator
Sitagliptin
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Dulaglutide, exenatide long-acting release (exe_lar), liraglutide and taspoglutide had significant lowering effect when compared with sitagliptin (HbA1c<7.0%) and insulin (HbA1c<6.5%).
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
Show in the study text Report a problemFND-2715881804
05HumanSystematic reviewEfficacy outcome
In adults with type 2 diabetes, liraglutide had a significant lowering effect on glycemic level (HbA1c<6.5%) compared with insulin.
In plain wordsIn adults with type 2 diabetes, liraglutide lowered blood sugar control measures more than insulin.
Peptide
Liraglutide
Outcome
DecreaseGlycemic level (HbA1c<6.5%) versus insulin
Study
n: not reported in source
Comparator
Insulin
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Dulaglutide, exenatide long-acting release (exe_lar), liraglutide and taspoglutide had significant lowering effect when compared with sitagliptin (HbA1c<7.0%) and insulin (HbA1c<6.5%).
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
Show in the study text Report a problemFND-2715881805

Studies that did not test the peptide alone4

In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Liraglutide.

06HumanNot a test of Liraglutide aloneSystematic reviewSafety outcome
In adults with type 2 diabetes, pooled GLP-1 receptor agonists except albiglutide increased the risk of hypoglycemia versus placebo.
In plain wordsIn adults with type 2 diabetes, GLP-1 drugs as a group, except albiglutide, raised the risk of low blood sugar compared with placebo.
Peptide
Liraglutide
Outcome
IncreaseHypoglycemia risk, pooled GLP-1 RAs versus placebo
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Metabolic and weight
Source sentences
Summary
Overall, all GLP-1 RAs except for albiglutide increased the risk of hypoglycemia when compared to placebo.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-2715881806
07HumanNot a test of Liraglutide aloneSystematic reviewSafety outcome
In adults with type 2 diabetes, pooled GLP-1 receptor agonists, except dulaglutide, reduced hypoglycemia incidence versus insulin.
In plain wordsIn adults with type 2 diabetes, GLP-1 drugs as a group, except dulaglutide, caused less low blood sugar than insulin.
Peptide
Liraglutide
Outcome
DecreaseHypoglycemia incidence, pooled GLP-1 RAs versus insulin
Study
n: not reported in source
Comparator
Insulin
Outcome group
Adverse events · Metabolic and weight
Source sentences
Summary
Reduction in the incidence of hypoglycemia was found for all GLP-1 RAs versus insulin (except for dulaglutide) and sulphonylureas.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-2715881807
08HumanNot a test of Liraglutide aloneSystematic reviewSafety outcome
In adults with type 2 diabetes, pooled GLP-1 receptor agonists reduced hypoglycemia incidence versus sulphonylureas.
In plain wordsIn adults with type 2 diabetes, GLP-1 drugs as a group caused less low blood sugar than sulphonylureas.
Peptide
Liraglutide
Outcome
DecreaseHypoglycemia incidence, pooled GLP-1 RAs versus sulphonylureas
Study
n: not reported in source
Comparator
Sulphonylureas
Outcome group
Adverse events · Metabolic and weight
Source sentences
Summary
Reduction in the incidence of hypoglycemia was found for all GLP-1 RAs versus insulin (except for dulaglutide) and sulphonylureas.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-2715881808
09HumanNot a test of Liraglutide aloneSystematic reviewEfficacy outcome
In adults with type 2 diabetes, all pooled GLP-1 receptor agonists decreased glycemic level versus placebo.
In plain wordsIn adults with type 2 diabetes, GLP-1 drugs as a group lowered blood sugar control measures more than placebo.
Peptide
Liraglutide
Outcome
DecreaseGlycemic level, pooled GLP-1 RAs versus placebo
Study
n: not reported in source
Comparator
Placebo
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
For glycemic level, decrease was found for all GLP-1 RAs versus placebo.
2 context sentences(design, population, supporting numbers)
Summary · context
Randomized controlled trials with available data comparing GLP-1 RAs with placebo or traditional anti-diabetic drugs in patients with type 2 diabetes.
Summary · context
78 trials with 13 treatments were included.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-2715881809

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
12 Oct 2026, 12:10 UTC
Study results updated
Version 1
9 Oct 2026, 03:05 UTC
First added · source update from Europe PMC

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