GLP-1 Receptor Agonists Linked to Lower Insulin Doses, HbA1c, Hospitalization in HF

insulin injected into stomach
insulin injected into stomach
Researchers examined the outcomes of GLP-1 receptor agonist therapy in patients with heart failure.

The following article is a part of conference coverage from the American Heart Association Scientific Sessions 2021, being held virtually from November 13 to 15, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by leading experts in cardiology. Check back for more from the AHA Scientific Sessions 2021.

Use of glucagon-like peptide 1 (GLP-1) receptor agonists was linked to reductions in insulin dose, hemoglobin A1c (HbA1c), body weight, and hospitalization in patients with heart failure (HF), according to study results presented at the American Heart Association (AHA) Scientific Sessions 2021, held from November 13 to 15, 2021.

Study researchers sought to analyze treatment outcomes in 151 patients with HF who were treated with GLP-1 receptor agonists at the Cardiometabolic Center Alliance, Kansas City, Missouri, between January 2019 and December 2020. Outcomes were compared with baseline visit to last Cardiometabolic Center visit. The median follow-up time was 6.6 (3.7-11) months.

Of 151 total participants, 88 had reduced ejection fraction, and 64 had preserved ejection fraction. At baseline, 92% of the cohort had type 2 diabetes; the remaining 8% had prediabetes; and 27% were receiving sodium/glucose cotransporter 2 inhibitors (SGLT-2i). At last visit, 92% of patients remained on GLP-1 receptor agonists, and 64% were on SGLT-2i. For patients with reduced ejection fraction, time on GLP-1 receptor agonist therapy was a median 5.4 (3 to 9.7) months and, for patients with preserved ejection fraction, 6.1 (3.4-11.8) months.

From baseline to last visit, both reduced ejection fraction and preserved ejection fraction groups had reductions in median total daily insulin doses (from 60-39 units, and 53-31 units, respectively; P <.002) and mean percent body weight (-6.2% and -7.9%, respectively; P <.001). Mean HbA1c levels also decreased among patients with reduced ejection fraction (from 7.7% to 6.9%; P <.001) and preserved ejection fraction (from 7.2% to 6.8%; P <.002).

Patients treated at the Cardiometabolic Center had lower rates of heart-failure-related hospitalization or urgent visits compared with prior care (13.6% vs 34.1% in reduced ejection fraction ([P <.001] and 15.99% vs 33.3% in preserved ejection fraction [P =.01]). Side effects were observed in 31% of patients, but only 6% discontinued GLP-1 receptor agonist therapy.

Researchers indicated that GLP-1 receptor agonist therapy was well tolerated and associated with reductions in insulin dose, HbA1c, and body weight. They also noted that the use of GLP-1 receptor agonists was further linked to a decreased risk for hospitalization or urgent visits for HF.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Sammour Y, Nassif M, Gunta P, et al. GLP-1 receptor agonists in heart failure: insights from a cardiometabolic center of excellence. Presented at: AHA Scientific Sessions 2021; November 13-15, 2021. Poster P230.


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