Efficacy and safety of semaglutide in glycemic control, body weight management, lipid profiles and other biomarkers among obese type 2 diabetes patients initiated or switched to semaglutide from other GLP-1 receptor agonists

Abstract Purpose Evidence of the efficacy and safety of semaglutide among patients with type 2 diabetes who were initiated on or were switched to semaglutide from other GLP-1 RAs remains limited. The objective of this study was to investigate the short-term effects of switching to semaglutide from other GLP-1 RAs. Methods This retrospective cohort study evaluated patients with type 2 diabetes who were initiated on or were switched to semaglutide due to poor diabetes control with other GLP-1 RAs or other medications, or obesity. HbA1c, body weight, serum creatinine, serum uric acid, parameters of lipid metabolism, and parameters of liver function were measured before and 6 months after administration of semaglutide. Results A total of 50 patients were registered in the study. After switching to semaglutide (n = 43), HbA1c and body weight significantly decreased (p < 0.01, p < 0.01), respectively. The same findings were observed in semaglutide-naïve patients (p = 0.04, p < 0.02) (n = 7). Serum uric acid, total cholesterol, triglycerides, and urinary albumin-creatinine ratio decreased significantly as well (p = 0.04, p = 0.04, p = 0.02, p = 0.04), whereas serum creatinine did not change significantly (p = 0.51). Conclusions Semaglutide showed excellent efficacy, even in patients switched from other GLP-1 RAs. Semaglutide appears to be a promising agent for blood glucose and body weight control in obese type 2 diabetes mellitus patients and could be more potent in treating type 2 diabetes than existing GLP-1 RAs.

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Efficacy and Safety of Semaglutide in Glycemic Control and Body Weight Management Among Obese Type 2 Diabetes Patients Initiated or Switched to Semaglutide From Other GLP-1 Receptor Agonists

10.21203/rs.3.rs-586388/v1 ◽

2021 ◽

Author(s):

Aki Okamoto ◽

Hirohide Yokokawa ◽

Tomoko Nagamine ◽

Hiroshi Fukuda ◽

Teruhiko Hisaoka ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Weight Control ◽

Efficacy And Safety ◽

Albumin Creatinine Ratio ◽

Body Weight Control

Abstract Background: Evidence of the efficacy and safety of semaglutide among patients with type 2 diabetes who were initiated on or were switched to semaglutide from other GLP-1 RAs remains limited. The objective of this study was to investigate the short-term effects of switching to semaglutide from other GLP-1 RAs.Methods: This retrospective cohort study evaluated patients with type 2 diabetes who were initiated on or were switched to semaglutide due to poor diabetes control with other GLP-1 RAs or other medications, or obesity. HbA1c, body weight, serum creatinine, serum uric acid, parameters of lipid metabolism, and parameters of liver function were measured before and 6 months after administration of semaglutide.Results: A total of 50 patients were registered: 21 men and 29 women, aged 51.3 years. Mean body mass index was 32.2 kg/m2, and serum C-peptide was 2.7mg/mL. After switching to semaglutide (n=43), HbA1c and body weight significantly decreased from 6.72 % to 6.22 % and from 86.5 kg to 82.7 kg, respectively. The same findings were observed in semaglutide-naïve patients (n=7). Serum uric acid, total cholesterol, triglycerides, and urinary albumin-creatinine ratio decreased significantly as well, whereas serum creatinine did not change significantly. Conclusion: Semaglutide showed excellent efficacy, even in patients switched from other GLP-1 RAs. Semaglutide appears to be a promising agent for blood glucose and body weight control in obese type 2 diabetes mellitus patients and could be more potent in treating type 2 diabetes than existing GLP-1 RAs.

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A STUDY OF SERUM URIC ACID LEVELS IN TYPE 2 DIABETES MELLITUS CASES AND ITS COMPARISON WITH THE SERUM CREATININE LEVELS

10.36106/paripex/0302859 ◽

2021 ◽

pp. 20-22

Author(s):

Shajahan Shajahan ◽

Koneru Sri Lahari ◽

P. Kiranmai

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Fasting Blood Glucose ◽

Control Group ◽

P Value

BACKGROUND:Type 2 Diabetes Mellitus is a major non-communicable disease resulting from insulin resistance and is associated with cardiovascular,neurological and renal complications.Recent studies show association of hyperuricemia and Diabetes Mellitus.Uric acid increases oxidative stress that leads to vascular dysfunction and high intra glomerular pressure leading to renal complications.High serum creatinine is an indicator of renal compromise. OBJECTIVES: To evaluate serum uric acid and serum creatinine levels in type 2 diabetes mellitus patients and to find association between them. METHODOLOGY: The study was conducted in Osmania general hospital. Fifty cases of established Type 2 Diabetes Mellitus formed the study group and 50 normal healthy individuals formed the control group. Serum uric acid, Fasting Blood Glucose (FBS) and serum creatinine were estimated by colorimetric enzymatic methods on Beckman coulter AU5800.Mean values were compared in cases and controls using student t- test.Study group was further studied under 2 subgroups with serum Uric acid < 7 mg/dl and ≥7 mg/dl.In these 2 subgroups the association of Serum uric acid with FBS and creatinine was analysed statistically. RESULTS: Serum uric acid were found high in cases(7.63+/- 3.36)as compared to controls(4.48+/- 1.09) p value < 0.001.Serum creatinine were also high in cases(1.59+/- 1.39 )as compared to controls ( 0.87+/- 0.29) p value <0.005.Study subgroup with serum uric acid ≥7 mg/dl was associated with high creatinine and high fasting blood sugar levels when compared to subgroup with serum uric acid <7 mg/dl. CONCLUSION: Our study showed increased serum uric acid and serum creatinine levels in cases when compared to controls.There was significant association between high serum uric acid and high creatinine levels in cases.Therefore,it is important to measure serum uric acid and serum creatinine levels in diabetics for early detection of renal pathology.

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A Retrospective Database Study of Liraglutide Persistence Associated with Glycemic and Body Weight Control in Patients with Type 2 Diabetes

Diabetes Therapy ◽

10.1007/s13300-019-0583-9 ◽

2019 ◽

Vol 10 (2) ◽

pp. 683-696

Author(s):

Cheli Melzer-Cohen ◽

Gabriel Chodick ◽

Lise Lotte N. Husemoen ◽

Nicolai Rhee ◽

Varda Shalev ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Weight Control ◽

Database Study ◽

Body Weight Control ◽

Retrospective Database

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Mediators of the effect of ertugliflozin on a composite kidney outcome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: analyses from VERTIS CV

European Heart Journal ◽

10.1093/eurheartj/ehab724.2925 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

D Z I Cherney ◽

M Segar ◽

A Pandey ◽

C P Cannon ◽

F Cosentino ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Body Weight ◽

Uric Acid ◽

Serum Uric Acid ◽

Atherosclerotic Cardiovascular Disease ◽

Composite Outcome ◽

Average Change ◽

Post Randomisation

Abstract Introduction Sodium–glucose cotransporter 2 (SGLT2) inhibitors have been shown to slow the decline of kidney function in outcome trials, but the biological mediator(s) underlying the therapeutic benefit are not well established. Purpose We performed a post-hoc analysis exploring potential mediators of the effects of the SGLT2 inhibitor ertugliflozin on the VERTIS CV exploratory kidney composite outcome (sustained 40% decrease from baseline in estimated glomerular filtration rate [eGFR], chronic kidney replacement therapy or kidney death). Methods In VERTIS CV, 8246 participants with type 2 diabetes mellitus and established atherosclerotic cardiovascular disease were randomised to placebo, ertugliflozin 5 mg or 15 mg (pooled for analyses, as prospectively planned), and were followed for a mean of 3.5 years. The hazard ratio (HR; 95% confidence interval) for the pre-specified exploratory kidney composite outcome was 0.66 (0.50, 0.88). Cox regression models were used to evaluate covariates that were significantly differentially changed from baseline with ertugliflozin treatment as candidate mediators, with a mediator identified as a covariate when added to an unadjusted model of randomised treatment assignment a) yielded a larger hazard ratio; and b) the mediator retained P<0.05 in the model (eGFR was excluded as a covariate). The percentage of mediation was determined by the proportional increase in the HR between the unadjusted and adjusted models for each post-randomisation period: early (first change from baseline measurement) and average (weighted average of change from baseline from all post-baseline measurements). Each potential mediator was tested individually, so across analyses, mediation % sums to >100%. Results Of 22 covariates significantly changed by ertugliflozin, nine were identified as potential mediators (Table). The covariates with a high percentage of mediation were those related to changes in blood erythrocytes (haemoglobin, haematocrit and red blood cell mass), with average changes in haemoglobin having the highest percentage of mediation (61.8%). Serum uric acid was associated with a mediation of 29.4% and 50.0% for the early and average post-randomisation effect periods, respectively. Early changes in glycated haemoglobin had a large mediation (50%), but the average change during the trial was not significant. Average change in serum albumin had a large mediation (29.4%). Average changes in body weight and systolic blood pressure had percentages of mediation of 41.2% and 14.7%, respectively. Conclusion Multiple factors may be involved in the reduction of the kidney composite outcome observed with ertugliflozin. In the short-term, changes in glycaemia had a high mediation effect. Over the long-term, changes suggestive of haemoconcentration and/or haematopoiesis (natriuresis-related effects), showed the highest percentage of mediation, followed by changes in serum uric acid and body weight (glucosuria-related effects). FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): Sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA in collaboration with Pfizer Inc., New York, NY, USA

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The Effect of Sodium Channel Blocker, Mexiletine, on Body Weight in Type 2 Diabetes Patients with Visceral Obesity

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.1177/1179551418825049 ◽

2019 ◽

Vol 12 ◽

pp. 117955141882504

Author(s):

Naohiko Ueno

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Uric Acid ◽

Waist Circumference ◽

Diabetic Neuropathy ◽

Serum Uric Acid ◽

Visceral Obesity ◽

Control Group ◽

Diabetes Patients

Objective: Mexiletine is an anti-arrhythmic agent also used for the treatment of painful diabetic neuropathy. In this study, the effect of mexiletine on body weight was evaluated in type 2 diabetes patients with diabetic neuropathy exhibiting visceral obesity. Methods: Type 2 diabetes patients with neuropathy exhibiting visceral obesity (n = 21) treated by mexiletine (300 mg/day) and a control group of type 2 diabetes patients with the same condition who received vitamin B12 (n = 12) were retrospectively evaluated. Body weight, waist circumference, hemoglobin A1c (HbA1c), blood pressure, liver function, serum lipids, and serum uric acid were assessed before and 6 months after the treatment. Results: Mexiletine significantly decreased body weight and waist circumference. The changes in body weight and waist circumference in 6 months in the mexiletine group were greater than in the control group. In metabolic parameters, there were significant decreases in triglyceride (TG) and serum uric acid. There were positive relationships between the change in body weight and the changes in TG, uric acid, alanine aminotransferase (ALT), and HbA1c. Conclusions: Mexiletine may affect body weight regulation. It ameliorated the metabolic parameters possibly by decreasing visceral fat. Further study should be performed to clarify the mechanism of the effect.

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The Synthesis and Evaluation of RGD−Conjugated Chitosan Gel as Daily Supplement for Body Weight Control

Materials ◽

10.3390/ma14164467 ◽

2021 ◽

Vol 14 (16) ◽

pp. 4467

Author(s):

Wei-Yao Chen ◽

Yu-Ting Chen ◽

Cherng-Jyh Ke ◽

Ching-Yun Chen ◽

Feng-Huei Lin

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Chronic Diseases ◽

Weight Control ◽

Rgd Peptide ◽

Health Food ◽

Short Term ◽

Body Weight Control

(1) Background: Obesity is one of the most widespread chronic diseases and increases the risk of several other chronic diseases, especially type 2 diabetes. (2) Methods: Endobarrier is a new medical device what is worn in the small intestines for the treatment of type 2 diabetes and obesity. However, given the invasive and other adverse effects of the Endobarrier, we propose the use of RGD peptide conjugated with chitosan (RC) as an alternative. (3) Results: The FTIR and NMR spectrum showed RGD peptide was successfully conjugated on chitosan and RGD−CT is retained in the small intestine even after digestion. In vitro of wst-1 and live and dead staining studies show that the RGD−CT gel is highly biocompatible and non-toxic. Rats treated with the RGD−CT gel for a short term showed significant decrease change more than 30% in body weight, while the blood and hematic biometrics were within normal values. (4) Conclusions: The RGD−CT gel is safe, suitable for the short-term, reducing visceral fat rate health food to control weight. In the future, it is expected to develop a safe, long-term effective, flexibility of use and low-side-effect anti-obesity therapy in the era of precision medicine by further modification.

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Higher Serum Uric Acid is a Risk Factor of Reduced Muscle Mass in Men with Type 2 Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-0805-2197 ◽

2018 ◽

Vol 129 (01) ◽

pp. 50-55 ◽

Cited By ~ 2

Author(s):

Ken-ichiro Tanaka ◽

Ippei Kanazawa ◽

Masakazu Notsu ◽

Toshitsugu Sugimoto

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Risk Factor ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Muscle Mass ◽

Regression Analyses

Abstract Objective Sarcopenia has been recognized as a diabetic complication, and hyperuricemia is often accompanied by type 2 diabetes mellitus (T2DM). However, it is unknown whether serum uric acid (UA) levels are associated with reduced muscle mass in T2DM. Methods We conducted a cross-sectional study to investigate the association of serum UA with muscle mass in 401 subjects with T2DM (209 men and 192 postmenopausal women). The relative skeletal muscle mass index (RSMI) was evaluated using whole-body dual-energy x-ray absorptiometry. Results Multiple regression analyses adjusted for body weight, age, serum creatinine, hemoglobin A1c (HbA1c), and duration of T2DM showed that serum UA was negatively associated with RSMI in all subjects and men with T2DM (β=−0.13, p=0.001 and β=−0.17, p=0.003, respectively). Moreover, logistic regression analyses adjusted for these confounding factors showed that a higher serum UA level was significantly associated with low RSMI in men with T2DM [odds ratio (OR)=1.94, 95% confidence interval (CI)=1.10–3.45 per SD increase, p=0.023]. In addition, higher serum UA levels were significantly associated with low RSMI after additional adjustment for age, duration of T2DM, HbA1c level, serum creatinine level, and sex in all subjects with T2DM [OR=1.80, 95% CI=1.20–2.72 per SD increase, p=0.005]. Conclusions The present study showed for the first time that higher serum UA is an independent risk factor of reduced muscle mass in men with T2DM.

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Association of hyperuricemia and renal involvement in type 2 diabetes mellitus

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183468 ◽

2018 ◽

Vol 6 (9) ◽

pp. 2958

Author(s):

Rumi Deori ◽

Ratan Kumar Kotokey ◽

Bedanta Bhuyan ◽

Swarnali Devi Baruah

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Renal Involvement ◽

Diabetic Patients ◽

Care Hospital

Background: Hyperuricemia maybe an independent risk factor for renal dysfunction in diabetic patients. On the other hand, albuminuria is considered as an indicator for early stages of diabetic nephropathy. The aim of our study was to find out any association between hyperuricemia and simple renal function tests to detect early renal involvement in type 2 diabetes mellitus for its early treatment and prevention for diabetic nephropathy.Methods: This hospital based cross-sectional study was conducted in 265 patients coming to medicine OPD and IPD in a tertiary care hospital in Assam, India. The subjects included were patients complaining of signs and symptoms of gout with or without Type 2 diabetes mellitus. The subjects were divided into two groups A and B, with and without type 2 diabetes respectively. They were selected randomly under the age group of 20 - 70 years old of both genders. Tests performed were serum uric acid, serum creatinine, blood urea, microalbuminuria, FBS and HbA1c estimated by standard methods.Results: In both diabetic and non-diabetic group, serum uric acid correlated positively and significantly with serum creatinine (>1.3mg/dl), blood urea (>40mg/dl) and microalbuminuria (p<0.05). Though serum uric acid did not correlate with HbA1c and FBS (p>0.05) in both the group. In non-diabetics, males were 6.95 times likely to have hyperuricemia than females.Conclusions: Hyperuricemia may be associated with early onset or incipient nephropathy in both diabetes and non- diabetic patient.

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Sodium-Glucose Cotransporter-2 (SGLT-2) Attenuates Serum Uric Acid (SUA) Level in Patients with Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2021/9973862 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Mazhar Hussain ◽

Asim Elahi ◽

Abid Hussain ◽

Javed Iqbal ◽

Lubna Akhtar ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Uric Acid ◽

Serum Uric Acid ◽

Controlled Trial ◽

Strong Association ◽

End Points ◽

Comparator Group ◽

Sodium Glucose Cotransporter

Background. Hyperuricemia has a strong association with diabetes mellitus. Hyperuricemia can lead to cardiovascular and renal complications in patients with diabetes. The goal of this study was to compare the effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors dapagliflozin and empagliflozin on serum uric acid (SUA) levels in patients with type 2 diabetes against traditional oral antihyperglycemic drugs (OADs). Methods. In this double-blind randomized controlled trial, 70 patients with type 2 diabetes and elevated SUA levels were assigned to two treatment groups. Patients in group A received SGLT-2 inhibitors tablet dapagliflozin 5 mg to 10 mg and empagliflozin 10 mg to 25 mg. Group B patients received OADs such as glimepiride, metformin, sitagliptin, gliclazide, and glibenclamide as monotherapy or combination therapy. The changes in SUA level were primary end points while changes in body weight and body mass index (BMI) from baseline to end point were secondary end points. Results. After four weeks of treatment, we noted a significant reduction of mean SUA levels in the SGLT-2 inhibitor group from 7.5 ± 2.5 to 6.3 ± 0.8 mg/dl versus comparator group from 7.1 ± 1.8 to 6.8 ± 2.2 mg/dl ( p = 0.001 ). Mean body weight was significantly reduced in the SGLT-2 group from 82 ± 10.4 to 78 ± 12.5 kg versus comparator group from 78 ± 13.2 to 79.2 ± 9.7 kg ( p = 0.001 ). Similarly, the mean BMI of patients in the SGLT-2 group was significantly reduced from 25.7 ± 3.2 to 24.2 ± 3.2 kg/m2 versus comparator group from 27.5 ± 4.2 to 28 ± 3.6 kg/m2 ( p = 0.002 ). Conclusion. SGLT-2 inhibitors have a strong potential to decrease SUA levels in patients with type 2 diabetes.

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