Anti-diabetic Effects of Liraglutide in Adolescents and Young Subjects With Type 1 Diabetes

Inclusion Criteria:

• INCLUSION CRITERIA:

  1. Females and males with Type 1 diabetes as ascertained by islet autoantibodies (GAD-65 and/or islet cell antibodies)
  2. Age 15-30 years - This age group is being chosen as most will have completed puberty with the accompanying physiologic phase of increased insulin resistance. In addition, this age group shows increased self-management capabilities. Extending the age up to 30 years will allow us to include young adults, since type 1 diabetes is frequently diagnosed in the late teen and early adult years. This study is not powered to detect differences in liraglutide efficacy in different age group but it may provide insight into the effectiveness in the teenage population, in whom optimal glycemic control is often a challenge.
  3. Type 1 diabetes duration greater than 1 year to ensure that a majority of subjects are beyond the partial remission period.
  4. Fasting C-peptide level ≤ 0.3 ng/ml.
  5. HbA1c level equal or less than 9%
  6. Insulin delivery by CSII - the choice is made to facilitate adherence to study drug and also to enable us have a homogeneous group to analyze without having to analyze the data for the covariants of CSII vs. multiple daily injection therapy.
  7. Subjects willing to wear a CGM sensor and perform home blood glucose monitoring four times daily and with symptoms of hypoglycemia.
  8. Subjects well-versed in carbohydrate counting.
  9. BMI < 95th% for age and gender.

Exclusion Criteria:

• EXCLUSION CRITERIA:

  1. Previous exposure to liraglutide
  2. History of abdominal surgery
  3. History of gastroparesis or gastrointestinal reflux disease;
  4. History of acute or chronic pancreatitis
  5. Cirrhosis or hepatic disease defined as transaminases levels > 3 times normal
  6. Impaired renal function defined as serum creatinine >1.5.
  7. HIV or Hepatitis C positive status
  8. Pregnant/breastfeeding females
  9. Individuals with steroid-induced or cystic fibrosis related diabetes
  10. Diabetic Ketoacidosis within 6 months of the study
  11. History of severe hypoglycemia (seizure, loss of consciousness) within 6 months of the study
  12. History of medullary thyroid cancer or MEN2 syndrome
  13. Any other life-threatening cardiac or non-cardiac disease
  14. Participation in a concurrent clinical trial or participation in a trial within 30 days preceding the study period.
  15. Unable to give informed consent/assent.

  16. Adolescents and adults who are considered underweight based on body mass index (BMI):

      1. For adolescents: BMI less than the 5th percentile
      2. For adults: BMI below 18.5