Macronutrient intake, appetite, food preferences and exocrine pancreas function after treatment with short‐ and long‐acting glucagon‐like peptide‐1 receptor agonists in type 2 diabetes

Aim To clarify the distinct effects of a long‐acting (liraglutide) and a short‐acting (lixisenatide) glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) on macronutrient intake, gastrointestinal side effects and pancreas function. Materials and Methods Fifty participants were randomized to either lixisenatide or liraglutide for a treatment period of 10 weeks. Appetite, satiety, macronutrient intake, gastrointestinal symptoms and variables related to pancreatic function and gastric emptying were assessed at baseline and after treatment. Results Both GLP‐1 RAs reduced macronutrient intake similarly. Weight loss and appetite reduction were not related to the delay in gastric emptying or gastrointestinal side effects (P > .05). Lipase increased significantly with liraglutide treatment (by 18.3 ± 4.1 U/L; P = .0001), but not with lixisenatide (−1.8 ± 2.4 U/L; P = .46). Faecal elastase and serum ß‐carotin levels (indicators for exocrine pancreas function) improved in both groups (P .05 for each variable). Conclusions Both GLP‐1 RAs comparably affected body weight, energy and macronutrient intake. Both treatments were associated with indicators of improved exocrine pancreas function. Reductions in appetite and body weight as a result of treatment with short‐ or long‐acting GLP‐1 RAs are not driven by changes in gastric emptying or gastrointestinal side effects.