Endocrine Abstracts

Introduction: Data from several clinical trials have shown positive effects of GLP1 analogue drugs on renal function in patients with type 2 diabetes (T2DM). However, there are very few reported results on its potential renoprotective effect in routine clinical practice. Our aim is to evaluate the effects of the addition of weekly dulaglutide (a GLP-1 analogue) to the normoglycemic treatment of patients with T2DM on renal function in a real-world cohort of patients.

Methods/design: Observational, retrospective study carried out in poorly controlled patients with T2DM in routine clinical practice conditions whom dulaglutide was added-on to their previous treatment. Renal fuction was evaluated by changes in estimated glomerular filtration rate (eGFR), creatinine serum levels and urine albumin/creatinine ratio (UACR) after dulaglutide add-on. Continuous variables are presented as mean and standard deviation or as median and interquartile range based on data distribution. Categorical variables are presented as frequencies. A multivariate analysis was performed to identify potential predictors for renal effects.

Results: Data from 46 patients (75% women; age: 60.5±9.2 years; HbA1c: 9.1 [8.4–9.7]%; duration of T2DM: 10 [6 – 16.5] years) were collected. Macroalbuminuria was present in 8.7%. After dulaglutide add-on (time for re-evaluation: 16 [12–24] weeks), a rise for eGFR was observed in 47.9% of the patients. Significant differences weren’t observed nor eGFR (83.7±18.1 vs 83.1±19.1 mL/min/1.73 m², P=0.36), or serum levels of creatinine (0.81±0.2 vs 0.83±0.2 mg/dl, P=0.26) after dulaglutide addition. A significant reduction in UACR was detected after intensification with the GLP-1 analogue (15 [7.4–71] vs 8.9 [4.6–22.1] mg/g, P<0.001). There was any reduction of AUCR in 76% of the cohort. Reduction in UACR was independently observed in a multivariate analysis model including diabetes duration, weigth loss, HbA1c reduction, use of ACE inhibitors and previous antidiabetic treatment

Conclusions: Addition of weekly dulaglutide in pooly controlled patients with T2DM led to improvement in renal function profile in routine clinical practice conditions. This effect was independently observed of any epidemiological or clinical variable.