Dulaglutide safely controls glucose in T2D with CKD

In patients with type 2 diabetes (T2D) with chronic kidney disease (CKD), once-weekly dosage with dulaglutide achieves adequate glycaemic control along with a reduced decline in estimated glomerular filtration rate (eGFR), reports a recent study.

Researchers conducted a retrospective analysis of 197 T2D patients with mild-to-severe CKD. All had been treated with dulaglutide for at least 3 months. Creatinine-based eGFR and glycated haemoglobin (HbA1c) measurements were compared before and after treatment.

At the time of dulaglutide initiation, the average HbA1c was 8.9 percent, while patients had a mean body mass index (BMI) of 29.1 kg/m². Patients were on dulaglutide treatment for a median of 16 months, after which researchers recorded a significant drop of 0.9 percentage points in HbA1c.

The proportion of patients achieving the HbA1c target of ≤7.0 percent and ≤6.0 percent were 27.0 percent and 18.8 percent, respectively, after dulaglutide treatment. Efficacy was significantly better in men (p=0.048) and those with higher baseline HbA1c (p<0.001), while it was significantly worse in those with obesity.

Of note, glucose-lowering efficacy of dulaglutide was comparable across all CKD stages. Moreover, dulaglutide treatment even reduced eGFR decline. Before treatment initiation, patients had an annual change of –2.41 mL/min/1.73 m² in eGFR, which slowed to –0.76 mL/min/1.73 m² after initiation. The difference between these rates was statistically significant (p=0.003).

“In conclusion … dulaglutide use improved glycaemic control irrespective of CKD stages. Additional benefits were also observed in reducing eGFR decline, particularly in patients with moderate CKD with proteinuria,” the researchers said.