GLP-1 receptor agonists for diabetes: a review of the cardiovascular, kidney and mortality outcomes

How effective are two non-insulin drugs when used in combination to treat patients with type 2 diabetes?


Posted by Medivizor on Apr 5, 2020 in Diabetes mellitus |

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In a nutshell

This study examined the effectiveness and safety of two types of non-insulin drugs used in combination to treat patients with uncontrolled type 2 diabetes (T2D). The results showed that the drug combination effectively reduced patients’ blood glucose levels and body weight and did not cause serious side effects.

Some background

Non-insulin drugs have improved treatment options for patients with type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) are two classes of non-insulin drugs. GLP1RAs include drugs such as liraglutide (Victoza) and dulaglutide (Trulicity). SGLT2i include drugs such as dapagliflozin (Farxiga) and canagliflozin (Invokana). 

It has been shown that GLP1RAs increase insulin levels and help weight loss. SGLT2i drugs reduce blood glucose (sugar) levels by acting on the kidneys and may help patients lose weight. It is unclear if GLP1RAs and SGLT2i complement each other and are safe when used together.

Methods & findings

Data for 212 patients with uncontrolled T2D that received GLP1RAs and SGLT2i combination treatment was analyzed. Patients were examined at three visits to their clinicians. The first was before they began treatment. The second occurred just after starting treatment (on average 5.5 months later). The third visit occurred on average 16.4 months after starting treatment.

Combination treatment reduced patients’ blood glucose levels and improved weight loss. HbA1c (a measure of average blood glucose levels over 3 months) was reduced by 12 mmol/mol (1.1%) between the first visit and the second. This remained stable for the third visit. By the third visit, 42% of patients had achieved target HbA1c levels of under 7%.

On average, patients lost 3.5 kg during the study. Almost 40% of patients reduced their weight by 5% or more.

188 patients (88%) did not require a change in their treatment during the study. 19 patients experienced side effects. The most common side effects were infections (10 patients) and frequent urination (5 patients).

The bottom line

The authors concluded that GLP1RA and SGLT2i combination treatment is effective and safe for patients with uncontrolled T2D.

The fine print

This study used medical records to analyze data and so may not have had all information relating to patients, such as type or brand of GLP1RA/SGLT2i drugs used. This study would benefit from a placebo group to provide fairer comparisons. 

Published By :

Clinical therapeutics

Original Title :

GLP1 receptor agonist and SGLT2 inhibitor combination: An effective approach in real-life clinical practice.

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