Intervention: Victoza
Trial phase: Phase 3
ATC code: A10BJ02
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Sex: Female
Age groups: Adult
Healthy volunteers: Accepts Healthy Volunteers
Participants at risk: 78
Group description: Metformin XR plus Liraglutide Metformin extended release (XR) 500 mg qd 2 weeks 500 mg bid 2 weeks 500 mg am, 1000 mg pm- 2 weeks 1000 mg bid- 84 weeks (end study) Liraglutide - start .6 mg SC QD step up to 1.2 mg to a max dose of 1.8 mg SC QD as tolerated

Metformin XR plus liraglutide: Metformin XR-500 qd for 2 weeks, 500 mg bid 2 weeks; 500 mg am, 1000 mg pm- 2 weeks - 1000 bid final dose Liraglutide- start 0.6 mg SC QD step up to 1.2 mg to a max dose of 1.8 mg SC QD as tolerated during the 4-wk non-forced dose-escalation period ( maximum allowed dose of 1.8 mg SC QD)
Eligibility criteria:
Inclusion Criteria:

Adult female 18 years to 45 years of age who experienced GDM within 52 weeks of index pregnancy
Actual BMI >25 kg/ m2
Written consent for participation in the study
Patient completed lactation
Dysglycemia (impaired fasting glucose [IFG}, impaired glucose tolerance [IGT} or IFG/IGT) and/or ß-cell dysfunction postpartum requiring pharmacological intervention (except type 1 or 2 diabetes)

Exclusion Criteria:

Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2

History of pancreatitis
Significant cardiovascular, cerebrovascular, renal, or hepatobiliary diseases in the past (viral hepatitis, toxic hepatic damage, jaundice of unknown etiology)
Serum liver enzymes (AST and/or ALT levels) exceeding more than twice normal laboratory values
Uncontrolled hypertension (systolic blood pressure>150 mm Hg and/or diastolic blood pressure >90 mm Hg)
Fasting serum triglycerides ≥800 mg/dl at screening. Lipid-lowering medications must have been maintained at the same dose for 3 months prior to enrollment
Hematological profiles considered to be clinically significant
Cholestasis during the past pregnancy
Presence of contradictions for GLP-1 receptor agonist or metformin administration such as allergy or hypersensitivity
Current use of metformin, thiazolidinediones, dipeptidyl peptidase-4 inhibitors or GLP-1 receptor agonist medications.
Use of drugs known to exacerbate glucose tolerance.
Use of prescription or over-the-counter weight-loss drugs
Diabetes postpartum or history of diabetes or prior use of medications to treat diabetes except gestational diabetes
Creatinine clearance less than 60 ml/min
History or currently undergoing chemotherapy or radiotherapy for cancer
Pregnancy planned during the coming two years
Currently breastfeeding
Exclusion criteria include any condition, which in the opinion of the investigator would place the subject at increased risk or otherwise make the subject unsuitable for participation in the study