Abstract: PUB121
Tirzepatide Improves Glycemic Control Better than Dulagutide in Patients Undergoing Hemodialysis
Session Information
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Otsuka, Emiko, Nagasaki Daigaku Daigakuin Ishiyakugaku Sogo Kenkyuka, Nagasaki, Nagasaki, Japan
- Kitamura, Mineaki, Nagasaki Daigaku Daigakuin Ishiyakugaku Sogo Kenkyuka, Nagasaki, Nagasaki, Japan
- Abe, Shinichi, Nagasaki Kidney Center, Nagasaki, Nagasaki, Japan
- Funakoshi, Satoshi, Nagasaki Kidney Center, Nagasaki, Nagasaki, Japan
- Nishino, Tomoya, Nagasaki Daigaku Daigakuin Ishiyakugaku Sogo Kenkyuka, Nagasaki, Nagasaki, Japan
Background
Glycemic control is crucial to reduce cardiovascular events and mortality in patients with type 2 diabetes undergoing hemodialysis. On the other hand, some anti-diabetic drugs are of limited use or contraindicated in patients undergoing hemodialysis.
Tirzepatide is a novel dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) agonist that can be used in patients undergoing hemodialysis. However, the safety and efficacy of tirzepatide in patients undergoing hemodialysis remain unclear. We aimed to compare the glycemic control between dulaglutide and tirzepatide in patients undergoing hemodialysis.
Methods
This study is a retrospective single-center study. We included patients with type 2 diabetes undergoing hemodialysis whose prescriptions for diabetes were transitioned from dulaglutide to tirzepatide at the Nagasaki Renal Center between June 2023 and August 2023. Blood glucose levels were evaluated using continuous glucose monitoring (CGM) for 7 days in both periods before and after switching from dulaglutide to tirzepatide. Time in range (TIR), time above range (TAR), time below range (TBR), and mean blood glucose levels, were analyzed using the Wilcoxon signed-rank test.
Results
We analyzed 14 patients (61.9 ± 9.9 years, male: female =11:3). After switching to tirzepatide, TIR increased to 50.8% from 42.7% (p=0.02), TAR decreased to 37.8% from 48.4% (p=0.02), and mean glucose levels decreased to 137.4 mg/dL from 156.6 mg/dL (p=0.006). However, TBR did not show significant change before and after switching to tirzepatide (11.3% and 8.9%) (p=0.75). Furthermore, there were obvious improvements in glycemic control on hemodialysis days; TIR increased from 44.8% to 52.2% (p=0.02), TAR decreased from 40.9% to 32.6% (p=0.07), and TBR did not increase (13.7% and 14.3%) (p=0.76). In contrast, there were no significant changes in TIR (47.9% and 51.7%) (p=0.25), and mean glucose levels (157.9 mg/dL and 141.3 mg/dL) (p=0.08), on non-hemodialysis days.
Conclusion
Tirzepatide improves glycemic control without increasing hypoglycemia compared to dulagutide in patients with type 2 diabetes undergoing hemodialysis.