Renal and metabolic effects of the association of GLP-1 receptor agonists and SGLT-2 inhibitors in individuals with type 2 diabetes: a retrospective observational study ("ReMeSG study")
Details
Under indefinite embargo.UNIL restricted access
State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_2F8C13101A26
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Renal and metabolic effects of the association of GLP-1 receptor agonists and SGLT-2 inhibitors in individuals with type 2 diabetes: a retrospective observational study ("ReMeSG study")
Director(s)
ZANCHI A.
Codirector(s)
KOSINSKI C.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2021
Language
english
Number of pages
31
Abstract
Aim: To evaluate metabolic and renal effects of the association of GLP-1 receptor
agonists and SGLT2 inhibitors in type 2 diabetes mellitus inadequately controlled patients with one of these treatments.
Method: A retrospective analyse of type 2 diabetes mellitus patients' data who had a GLP-1 receptor agonist / SGLT-2 inhibitor combination for at least one year was conducted. Primary outcomes were eGFR, albumin-to-creatinine ratio, weight, BMI and glycated hemoglobin. Secondary outcomes were systolic and diastolic blood pressure, LDL cholesterol and triglycerides levels. Patients were separated into two treatment groups: GLP-1Ra on top of and SGLT2i on top of, according to the order in which they received their treatment. Paired t-tests and repeated measures ANOVA were performed to evaluate the difference between values of the variables at the initiation of dual therapy vs at different time points after it. Paired t-tests were also performed between both treatment groups to evaluate if there was a difference between them at a same time point.
Results: No significant results were found for renal parameters. Paired t-tests showed a significant decrease in weight from the third month for both groups combined, with persistence of this decrease up to 3 years (- 4.63 kg) compared to weight at the initiation of dual therapy. There was no significant difference in weight decrease between the two treatment groups at 3 years. In terms of glycated hemoglobin, paired t-test showed a significant decrease in HbA1c the third month for both groups combined (- 0.76%) with then a stabilization and a decrease of - 0.87% (P < 0.05) at one year, compared to HbA1c at the initiation of dual therapy. At two and three years, there was then a slight increase in HbA1c, although it remained below the initial HbA1c.
Conclusion: There were too few patients included in this study to obtain significant results regarding the renal effects of dual therapy. For weight and HbA1c, the effect of the dual therapy was additive, which confirms the conclusion that similar studies found.
agonists and SGLT2 inhibitors in type 2 diabetes mellitus inadequately controlled patients with one of these treatments.
Method: A retrospective analyse of type 2 diabetes mellitus patients' data who had a GLP-1 receptor agonist / SGLT-2 inhibitor combination for at least one year was conducted. Primary outcomes were eGFR, albumin-to-creatinine ratio, weight, BMI and glycated hemoglobin. Secondary outcomes were systolic and diastolic blood pressure, LDL cholesterol and triglycerides levels. Patients were separated into two treatment groups: GLP-1Ra on top of and SGLT2i on top of, according to the order in which they received their treatment. Paired t-tests and repeated measures ANOVA were performed to evaluate the difference between values of the variables at the initiation of dual therapy vs at different time points after it. Paired t-tests were also performed between both treatment groups to evaluate if there was a difference between them at a same time point.
Results: No significant results were found for renal parameters. Paired t-tests showed a significant decrease in weight from the third month for both groups combined, with persistence of this decrease up to 3 years (- 4.63 kg) compared to weight at the initiation of dual therapy. There was no significant difference in weight decrease between the two treatment groups at 3 years. In terms of glycated hemoglobin, paired t-test showed a significant decrease in HbA1c the third month for both groups combined (- 0.76%) with then a stabilization and a decrease of - 0.87% (P < 0.05) at one year, compared to HbA1c at the initiation of dual therapy. At two and three years, there was then a slight increase in HbA1c, although it remained below the initial HbA1c.
Conclusion: There were too few patients included in this study to obtain significant results regarding the renal effects of dual therapy. For weight and HbA1c, the effect of the dual therapy was additive, which confirms the conclusion that similar studies found.
Keywords
GLP-1 receptor agonist, SGLT-2 inhibitor, dual therapy, diabetes mellitus, renal effect
Create date
07/09/2022 13:33
Last modification date
27/09/2023 6:59
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