Boye KS, et al. - This research entailed the characterization of the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) with and without renal impairment. In addition, experts inspected the effects of such use on the clinical outcomes of estimated glomerular filtration rate (eGFR) and glycated hemoglobin (A1c). The use of GLP-1 RAs was limited in patients with a higher degree of renal impairment disease in clinical practice. Data shed light on the connection between the use of GLP-1 RAs with a notably smaller decline in eGFR and a larger reduction in A1c over the 1 year following therapy initiation when compared to other glucose-lowering agents (GLAs).

Methods

• Researchers cumulated data from the Practice Fusion electronic health records database from 1 January 2012 through 30 April 2015.
• They assessed adults with T2D who received serum creatinine laboratory tests and initiated therapy with a GLP-1 RA (N = 3,225) or other glucose-lowering agent (GLA) (N = 37,074).
• Herein, the GLP-1 RA cohort was matched to cohorts initiating therapy any other GLA.
• Using multivariable analyses, a scrutiny was conducted of the link between GLP-1 RA use and changes in eGFR or A1c at 1 year after therapy initiation.

Results

• Therapy with a GLP-1 RA was initiated in only 5.7% of patients with an eGFR of < 30 and ≥ 15 mL/min/1.73 m² and 3.6% of patients with an eGFR of < 15 mL/min/1.73 m².
• In contrast with other GLAs, at 1-year after initiation of therapy, the use of a GLP-1 RA exhibited correlation with a substantially smaller decline in eGFR (- 0.80 vs - 1.03 mL/min/1.73 m²; P=0.0005), a notably smaller tendency of having a ≥ 30% reduction in eGFR (2.19 vs 3.14%; P < 0.0001), and a markedly larger reduction in A1c (- 0.48 vs - 0.43; P=0.0064).