Liraglutid and insuline resistance at heart failure patient.

Main Article Content

Stefan Farsky, M.D, FESC


Cardiologists play a key role in the identification and subsequent management of patients with cardiovascular disease and comorbid obesity. In addition to the overall cardiovascular risk profile one must also consider the residual cardiovascular risk in patients in whom, despite properly treated comorbidities, dyslipidemia and hypertension), in connection with ongoing obesity, the chronic inflammatory process of the vascular wall continues, and myocardial fibrosis and the HFpEF phenotype develop. Since last year, it has also been able to indicate modern pharmacotherapy such as GLP-1 receptor agonists (RA) and SGLT2 inhibitors for indications other than DM2T. GLP-1 receptor agonists, specifically liraglutide, regulates appetite by increasing the feeling of satiety while simultaneously reducing the feeling of hunger and the desire to consume more food. This leads to significant weight loss and subsequent reduction in the risk of hypertension, arrhythmias (including atrial fibrillation), ischemic heart disease and heart failure. It can be expected that this type of treatment for patients with the HFpEF phenotype and obesity will gain significant traction in the near future. In this case liraglutid application led to signiffcant weight reduction. This enabled reduction in the extent of pharmacotherapy especially extreme reduction of daily insulin burden dosage together with dramatic decrease blood glucose levels near to normal values. The most probable explanation for this impressive improvement is the insulin resistance reduction together with weight reduction. This was accompanied with improvement of the patient’s quality of life, especially of effort dyspnoe reduction and with the renal function improvement too.

Keywords: Liraglutid and insuline resistance, heart failure patient

Article Details

How to Cite
FARSKY, Stefan. Liraglutid and insuline resistance at heart failure patient.. Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023. ISSN 2375-1924. Available at: <>. Date accessed: 19 july 2024. doi:
Case Reports


1. Mandviwala T, Khalid U, Deswal A. Obesity and Cardiovascular Disease: Risk Factor or a Risk Marker.Curr Atheroscler Rep. 2016; 18(5):21.

2. Pereira LLS, Moraes GM, Castro Carneiro AC, Moreira V, Bello JH,Prazeres CE, et al. Relationship between Obesity and Coronary Artery Disease Defined by Coronary Computed Tomography Angiography. Int J Cardiovasc Sci. 2020;33(1):57

3. Obesity and Cardiovascular Disease. A Scientific Statement From the American Heart Association. Circulation. 2021;143:e984–e1010DOI:10.1161/CIR.0000000000000973

4. Madala MC et al. , CRUSADE investigators. Obesity and Age of First NSTEMI. Am Coll Cardiol 2008, 52:979-985.

5. De Koining L et al. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007, 28(7):850-6

6. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11-22.

7. le Roux CW, Astrup A, Fujioka K, Greenway F, Lau DCW, Van Gaal L, Ortiz RV, Wilding JPH, Skjøth TV, Manning LS, Pi-Sunyer X; SCALE Obesity Prediabetes NN8022-1839 Study Group. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017 Apr 8;389(10077):1399-1409.

8. Wadden TA, Tronieri JS, Sugimoto D, Lund MT, Auerbach P, Jensen C, Rubino D. Liraglutide 3.0 mg and Intensive Behavioral Therapy (IBT) for Obesity in Primary Care: The SCALE IBT Randomized Controlled Trial. Obesity (Silver Spring). 2020 Mar; 28(3):529-536.

9. Wadden TA, Hollander P, Klein S, Niswender K, Woo V, Hale PM, Aronne L; NN8022-1923 Investigators. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. Int J Obes (Lond). 2013 Nov;37(11):1443-51

10. Blackman A, Foster GD, Zammit G, Rosenberg R, Aronne L, Wadden T, Claudius B, Jensen CB, Mignot E. Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial. Int J Obes (Lond). 2016 Aug; 40(8):1310-9.

11. Garvey WT, Birkenfeld AL, Dicker D, Mingrone G, Pedersen SD, Satylganova A, Skovgaard D, Sugimoto D, Jensen C, Mosenzon O. Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin: The SCALE Insulin Randomized Controlled Trial. Diabetes Care. 2020 May;43(5):1085-1093.

12. Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA; NN8022-1922 Study Group. Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA. 2015 Aug 18; 314(7):687-99.

13. van Can J, Sloth B, Jensen CB, Flint A, Blaak EE, Saris WH. Effects of the once-daily GLP-1 analog liraglutide on gastric emptying, glycemic parameters, appetite and energy metabolism in obese, non-diabetic adults. Int J Obes (Lond). 2014 Jun; 38(6):784-93.

14. Wharton S, Liu A, Pakseresht A, Nørtoft E, Haase CL, Mancini J, Power GS, Vanderlelie S, Christensen RAG. Real-World Clinical Effectiveness of Liraglutide 3.0 mg for Weight Management in Canada. Obesity (Silver Spring). 2019 Jun; 27(6):917-924.

15. Wharton S, Haase CL, Kamran E, Liu A, Mancini J, Neish D, Pakseresht A, Power GS, Christensen RAG. Weight loss and persistence with liraglutide 3.0 mg by obesity class in the real-world effectiveness study in Canada. Obes Sci Pract. 2020 May 9; 6(4):439-444.

16. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016 Jul 28;375(4):311-22.

17. Sattar N et al. Cardiovascular mortality and kidney outcomes with GLP-1 agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol 2021; 9(10):653-662.

18. Volpe, M., Borghi, C., Cameli, M., Cianflone, D., Cittadini, A., Maggioni, A. P., Filardi, P. P., Rosano, G., Senni, M., Sinagra, G. 2023. How cardiologists can manage excess body weight and related cardio-vascular risk. An expert opinion. Int J Cardiol. 2023 Jun 15; 381:101-104.

19. Neeland, I. J., Ayers, C. R., Rohat¬gi, A. K., Turer, A. T., Berry, J. D., Das, S. R., Vega, G. L., Khera, A., McGuire, D. K., Grundy, S. M., de Lemos, J. A. 2013. Associations of visceral and abdominal subcutane¬ous adipose tissue with markers of cardiac and metabolic risk in obe¬se adults. Obesity (Silver Spring). 2013 Sep;21(9):E439-47. doi: 10.1002/oby.20135. Epub 2013 May 19. PMID: 23687099; PMCID: PMC3751977.

20. Neeland, I. J, Marso, S. P., Ayers, C. R., Lewis, B., Oslica, R., Francis, W., Rod¬der, S., Pandey, A., Joshi, P. H. 2021. Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial. Lancet Diabetes Endocrinol. 2021 Sep;9(9):595-605. doi: 10.1016/S2213-8587(21)00179-0. Epub 2021 Aug 3. PMID: 34358471.