Real-world impact of adding a glucagon-like peptide-1 receptor agonist compared with basal insulin on metabolic targets in adults living with type 2 diabetes and chronic kidney disease already treated with a sodium-glucose co-transporter-2 inhibitor: The Impact GLP-1 CKD study.
Diabetes Obes Metab
; 26(10): 4674-4683, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-39113258
ABSTRACT
AIM:
To compare the effectiveness of adding a glucagon-like peptide-1 receptor agonist (GLP-1 RA) with adding basal insulin among adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) already treated with a sodium-glucose co-transporter-2 inhibitor (SGLT2i) and not reaching their glycaemic control targets.METHODS:
A retrospective analysis of the Canadian LMC Diabetes Registry was conducted. Adults who initiated a GLP-1 RA were matched 11 to adults who initiated basal insulin in a T2D and CKD population. Changes in metabolic outcomes were evaluated at 26-52 weeks following the therapy start date.RESULTS:
Propensity score matching was used to match participants who initiated a GLP-1 RA to participants who initiated basal insulin (n = 153/cohort). A significantly greater reduction in HbA1c at 26-52 weeks of follow-up was observed in the GLP-1 RA cohort compared with the basal insulin cohort (-1.3% ± 1.4% vs. -1.1% ± 1.4%, P = .03). Weight was significantly reduced (-3.4 ± 3.7 vs. 2.6 ± 4.5 kg, P < .001), and the estimated glomerular filtration rate decline slowed significantly (-0.3 ± 8.2 vs. -2.4 ± 10.4 mL/min/1.73m2, P = .02), but the change in albuminuria was not significantly different (-5.7 ± 38.1 vs. -0.5 ± 38.3 mg/mmol, P = .47) at follow-up in the GLP-1 RA group compared with the basal insulin group. No differences in self-reported hypoglycaemic events per week and therapy discontinuations were reported between the cohorts.CONCLUSIONS:
The study shows the real-world effectiveness of GLP-1 RA therapy for T2D and CKD. GLP-1 RAs provided superior reductions in HbA1c and weight, and greater kidney protection, compared with basal insulin among adults with T2D and CKD already treated with an SGLT2i.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas Glicadas
/
Diabetes Mellitus Tipo 2
/
Quimioterapia Combinada
/
Insuficiência Renal Crônica
/
Receptor do Peptídeo Semelhante ao Glucagon 1
/
Inibidores do Transportador 2 de Sódio-Glicose
/
Hipoglicemiantes
/
Insulina
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article