Long Term Effects of Liraglutide in Japanese Patients with type 2 Diabetes Among the Subgroups with Different Renal Functions: Results of 2-Year Prospective Study

Abstract Aims Very few studies have ever examined the effects of long-term (>1 year) administration of liraglutide in patients with type 2 diabetes mellitus (T2DM) and renal impairment. Therefore, we conducted a 2-year study to prospectively examine the effects of liraglutide in those patients. Methods A total of 148 patients with T2DM were enrolled and treated with liraglutide (0.6 or 0.9 mg/day). 97 patients completed the 2-year study without protocol deviations. These patients were divided into 3 groups according to the baseline estimated glomerular filtration ratio (eGFR) (in mL/min/1.73 m2): group A, ≥60 (n=39); group B, ≥30 to <60 (n=38); and group C, <30 (n=20). The changes in blood and urine variables, and echocardiographic left ventricular mass index (LVMI) from baseline to 2 years were analyzed in each group. Primary outcomes were changes of the renal parameters of eGFR and albuminuria after the treatment of liraglutide. Results Blood glucose and systolic blood pressure decreased significantly after 24 months of liraglutide treatment in all groups compared with baseline (p<0.05). The eGFR increased significantly in group B (p<0.05), and remained unchanged in groups A and C. Albuminuria and LVMI decreased significantly in all 3 groups compared with baseline (p<0.05). Conclusions These findings suggest that 2 years of liraglutide treatment in Japanese patients with T2DM and impaired renal function was effective in terms of suppressing the deterioration of renal function, and reducing albuminuria. Long-term liraglutide treatment also improved glycemic control and blood pressure, and reduced left ventricular hypertrophy in this study.

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Long-term blood pressure variability, incidence of hypertension and changes in renal function in type 2 diabetes

Journal of Hypertension ◽

10.1097/hjh.0000000000002543 ◽

2020 ◽

Vol 38 (11) ◽

pp. 2279-2286

Author(s):

Francesca Viazzi ◽

Elisa Russo ◽

Antonio Mirijello ◽

Paola Fioretto ◽

Carlo Giorda ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Renal Function ◽

Blood Pressure Variability

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Long-Term Effects of a Very Low Carbohydrate Compared With a High Carbohydrate Diet on Renal Function in Individuals With Type 2 Diabetes

Medicine ◽

10.1097/md.0000000000002181 ◽

2015 ◽

Vol 94 (47) ◽

pp. e2181 ◽

Cited By ~ 20

Author(s):

Jeannie Tay ◽

Campbell H. Thompson ◽

Natalie D. Luscombe-Marsh ◽

Manny Noakes ◽

Jonathan D. Buckley ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

High Carbohydrate Diet ◽

Long Term Effects ◽

Carbohydrate Diet ◽

High Carbohydrate ◽

Low Carbohydrate

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Safety and effectiveness of ipragliflozin in Japanese patients with type 2 diabetes mellitus and impaired renal function: subgroup analysis of a 3-year post-marketing surveillance study (STELLA-LONG TERM)

Diabetology International ◽

10.1007/s13340-020-00470-6 ◽

2020 ◽

Author(s):

Kazuyuki Tobe ◽

Hiroshi Maegawa ◽

Ichiro Nakamura ◽

Satoshi Uno

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Renal Function ◽

Impaired Renal Function ◽

Japanese Patients ◽

Post Marketing Surveillance ◽

Post Marketing

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Long-term effects of tight blood pressure and glucose control in type 2 diabetes

Nature Clinical Practice Nephrology ◽

10.1038/ncpneph0973 ◽

2008 ◽

Vol 4 (12) ◽

pp. 645-645

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Glucose Control ◽

Long Term Effects

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Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Journal of Atherosclerosis and Thrombosis ◽

10.5551/jat.4663 ◽

2010 ◽

Vol 17 (11) ◽

pp. 1132-1140 ◽

Cited By ~ 24

Author(s):

Yoshimitsu Yamasaki ◽

Naoto Katakami ◽

Shigetaka Furukado ◽

Kazuo Kitagawa ◽

Kazuyuki Nagatsuka ◽

...

Keyword(s):

Type 2 Diabetes ◽

Carotid Atherosclerosis ◽

Japanese Patients ◽

Recent History ◽

Long Term Effects ◽

History Of

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Renal Effects of Sulodexide in Type 2 Diabetic Patients without Nephrotic Range Proteinuria

Journal of Diabetes Research ◽

10.1155/2020/2984680 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Kachonsak Yongwatana ◽

Ouppatham Supasyndh ◽

Bancha Satirapoj

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Renal Function ◽

Diabetic Nephropathy ◽

Control Group ◽

Diabetic Patients ◽

Long Term Effects ◽

Renal Disease Progression ◽

Significant Difference

Background. Glycosaminoglycan plays an important role in the maintenance of glomerular charge selectivity of diabetic nephropathy. Sulodexide, a mixture of naturally occurring glycosaminoglycan polysaccharide components, has shown a nephroprotective effect in an experimental model of diabetic nephropathy. Although sulodexide reduced albuminuria in patients with type 1 and type 2 diabetes, long-term effects in patients with type 2 diabetes with significant proteinuria have not been established. Objectives. The study was aimed at investigating the effects of sulodexide on proteinuria and renal function in patients with type 2 diabetes and nephropathy. Methods. Fifty-two patients with proteinuria between 500 and 3000 mg/day received sulodexide 200 mg/day for 12 months, while 56 matched patients with type 2 diabetes constituted the control group. All patients received standard metabolic and blood pressure controls. Primary outcome was evaluated as percentage of reduced proteinuria compared with the control group. Renal function was assessed using estimated glomerular filtration rate (GFR). Results. Proteinuria significantly increased in the control group [0.9 (IQR 0.3 to 1.78) to 1.16 (IQR 0.44 to 2.23) g/gCr, P=0.001], whereas it remained stable in the sulodexide group [0.66 (IQR 0.23 to 0.67) to 0.67 (IQR 0.17 to 1.51) g/gCr, P=0.108]. At 12 months, proteinuria was higher by 19.4% (IQR 10.3 to 37.6) in the control group while proteinuria was lower by -17.7% (IQR -53.1 to 3.2) in the sulodexide group with a significant difference between groups (P=0.001). Renal function was noted as a change of estimated GFR, and serum creatinine decreased significantly during the study in both groups but did not significantly differ between groups. No significant changes in the blood pressure, fasting plasma glucose, and hemoglobin A1C were reported. Conclusion. In addition to standard treatment, sulodexide is efficient in maintaining proteinuria in patients with type 2 diabetes with nonnephrotic range proteinuria, but it did not provide an additional benefit concerning renal disease progression.

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Long-term safety and efficacy of alogliptin, a DPP-4 inhibitor, in patients with type 2 diabetes: a 3-year prospective, controlled, observational study (J-BRAND Registry)

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001787 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001787

Author(s):

Kohjiro Ueki ◽

Yukio Tanizawa ◽

Jiro Nakamura ◽

Yuichiro Yamada ◽

Nobuya Inagaki ◽

...

Keyword(s):

Type 2 Diabetes ◽

Observational Study ◽

Real World ◽

Safety And Efficacy ◽

The Real ◽

Real World Setting ◽

Group A ◽

Group B

IntroductionGiven an increasing use of dipeptidyl peptidase-4 (DPP-4) inhibitors to treat patients with type 2 diabetes mellitus in the real-world setting, we conducted a prospective observational study (Japan-based Clinical Research Network for Diabetes Registry: J-BRAND Registry) to elucidate the safety and efficacy profile of long-term usage of alogliptin.Research design and methodsWe registered 5969 patients from April 2012 through September 2014, who started receiving alogliptin (group A) or other classes of oral hypoglycemic agents (OHAs; group B), and were followed for 3 years at 239 sites nationwide. Safety was the primary outcome. Symptomatic hypoglycemia, pancreatitis, skin disorders of non-extrinsic origin, severe infections, and cancer were collected as major adverse events (AEs). Efficacy assessment was the secondary outcome and included changes in hemoglobin A1c (HbA1c), fasting blood glucose, fasting insulin and urinary albumin.ResultsOf the registered, 5150 (group A: 3395 and group B: 1755) and 5096 (3358 and 1738) were included for safety and efficacy analysis, respectively. Group A patients mostly (>90%) continued to use alogliptin. In group B, biguanides were the primary agents, while DPP-4 inhibitors were added in up to ~36% of patients. The overall incidence of AEs was similar between the two groups (42.7% vs 42.2%). Kaplan-Meier analysis revealed the incidence of cancer was significantly higher in group A than in group B (7.4% vs 4.8%, p=0.040), while no significant incidence difference was observed in the individual cancer. Multivariate Cox regression analysis revealed that the imbalanced patient distribution (more elderly patients in group A than in group B), but not alogliptin usage per se, contributed to cancer development. The incidence of other major AE categories was with no between-group difference. Between-group difference was not detected, either, in the incidence of microvascular and macrovascular complications. HbA1c and fasting glucose decreased significantly at the 0.5-year visit and nearly plateaued thereafter in both groups.ConclusionsAlogliptin as a representative of DPP-4 inhibitors was safe and durably efficacious when used alone or with other OHAs for patients with type 2 diabetes in the real world setting.

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