Liraglutide and Vildagliptin compared for short-term effects on insulin secretion and sensitivity in Sub-Saharan African Type 2 Diabetes patients

Managing Type 2 Diabetes Mellitus (T2DM) effectively often requires strategies beyond conventional oral glucose-lowering agents, especially in populations with unique metabolic profiles. Incretinomimetics, including Glucagon-Like Peptide-1 receptor agonists (GLP-1R agonists) like Liraglutide and Dipeptidyl Peptidase-4 inhibitors (DPP-4i) like Vildagliptin, are crucial therapeutic options. While GLP-1R agonists directly mimic endogenous GLP-1 to enhance insulin secretion and sensitivity, DPP-4i prolong the half-life of native GLP-1 by inhibiting its degradation. The short-term comparative efficacy of these two distinct incretin-based strategies on insulin secretion and insulin sensitivity in a Sub-Saharan African T2DM population, particularly those naive to incretinomimetics, remains an important clinical question.

This single-blinded, randomized controlled clinical trial enrolled 14 uncontrolled Type 2 Diabetes Mellitus patients (HbA1c ≥7%) in a Sub-Saharan African population. Participants were already on mono or bi oral anti-diabetic therapy but naive to incretinomimetic treatments. They were randomized into two arms for 14 days. The experimental arm received Liraglutide via subcutaneous injection, starting at 0.6mg/day for the first week, then increasing to 1.2mg/day for the second week. The active comparator arm received Vildagliptin 100mg/day orally. The primary endpoints were 14-day changes in insulin secretion and insulin sensitivity between the two treatment groups.