Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Cardiovascular Risk Management in Patients With Type 2 Diabetes Mellitus: A Systematic Review&#x0D;

Parab, Panah; Chaudhary, Priti; Mukhtar, Sonia; Moradi, Ali; Kodali, Athri; Okoye, Chiugo; Klein, Dhadon; Mohamoud, Iman; Olanisa, Olawale  O; Hamid, Pousette

doi:10.7759/cureus.45487

Cited by 7 publications

(4 citation statements)

References 33 publications

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“…GLP-1 RA, a novel class of glucose-lowering agents, has demonstrated cardiorenal protection in T2DM patients in trials focusing on cardiovascular outcomes ( 19 – 21 ). Clinical guidelines endorse GLP-1 RA as the primary glucose-lowering agents for treating T2DM patients with concurrent atherosclerotic cardiovascular disease and as a secondary option for DKD treatment ( 1 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of polyethylene glycol loxenatide in treating mild-to-moderate diabetic kidney disease in type 2 diabetes patients: a randomized, open-label, clinical trial

Cao,

Zhao

et al. 2024

Front. Endocrinol.

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ObjectiveThis study aimed to evaluate the efficacy and safety of polyethylene glycol loxenatide (PEG-Loxe) compared to those of dapagliflozin in patients with mild-to-moderate diabetic kidney disease (DKD), a prevalent microvascular complication of type 2 diabetes mellitus (T2DM). The study is set against the backdrop of increasing global diabetes incidence and the need for effective DKD management.MethodsThis study constituted a single-center, randomized, open-label, clinical trial. The trial included patients with mild-to-moderate DKD and suboptimal glycemic control. Eligible participants were randomly allocated to one of the two groups for treatment with either PEG-Loxe or dapagliflozin. The primary endpoint was the change in UACR from baseline at 24 weeks.ResultsOverall, 106 patients were randomized and 80 patients completed the study. Following 24 weeks of treatment, the PEG-Loxe group exhibited a mean percent change in baseline UACR of −29.3% (95% confidence interval [CI]: −34.8, −23.7), compared to that of −31.8% in the dapagliflozin group (95% CI: −34.8, −23.7). Both PEG-Loxe and dapagliflozin showed similar efficacy in reducing UACR, with no significant difference between the groups (p = 0.336). The HbA1c levels decreased by −1.30% (95% CI: −1.43, −1.18) in the PEG-Loxe group and by −1.29% (95% CI: −1.42, −1.17) in the dapagliflozin group (p = 0.905). The TG levels decreased by −0.56 mmol/L (95% CI: −0.71, −0.42) in the PEG-Loxe group and −0.33 mmol/L (95% CI: −0.48, −0.19) in the dapagliflozin group (p = 0.023). Differences in TC, HDL-C, LDL-C, SBP, and DBP levels between the groups were not statistically significant (all p > 0.05). Safety profiles were consistent with previous findings, with gastrointestinal adverse events being more common in the PEG-Loxe group.ConclusionsPEG-Loxe is as effective as dapagliflozin in improving urine protein levels in patients with mild-to-moderate DKD and offers superior benefits in improving lipid profiles. These findings support the use of PEG-Loxe in DKD management, contributing to evidence-based treatment options.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR2300070919.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of polyethylene glycol loxenatide in treating mild-to-moderate diabetic kidney disease in type 2 diabetes patients: a randomized, open-label, clinical trial

Cao,

Zhao

et al. 2024

Front. Endocrinol.

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“…The additional benefits associated with the use of antidiabetic medications include weight reduction, improvement in lipid profile, decreased risk of cardiovascular complications and cardiovascular events for selected GLP-1 receptor agonists and certain SGLT2 inhibitors, reduction in the risk of progression of diabetic kidney disease, and decreased frequency of hospitalizations due to heart failure [34,35].…”

Section: Treatmentmentioning

confidence: 99%

Classification, Symptoms, Treatment and Preventive Strategies of Diabetes. A guide to the basic

Madoń,

Proszowska,

Sieniawska

et al. 2024

J Educ Health Sport

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Introduction Diabetes is a chronic metabolic disorder characterized by impaired insulin secretion and action. Risk factors for diabetes include age, obesity, low physical activity, hypertension, lipid disorders, and genetic predisposition. Symptoms of diabetes typically include frequent urination, weight loss, excessive thirst, weakness, fatigue, susceptibility to fungal infections and recurrent boils. Diabetes is a prevalent and significant societal concern, often causing anxiety, uncertainty and a sense of danger upon diagnosis. Aim of the study The aim of the study is to provide a comprehensive analysis of diabetes, including its classification, characteristic symptoms, the most frequently occurring diabetes-related complications, and preventive strategies. Through a detailed discussion of these issues, our goal is to increase public awareness of diabetes and provide readers with comprehensive knowledge about this disease. Material and method This article presents the current state of knowledge about diabetes. A literature review was conducted using the PubMed, Google Scholar and Web of Science databases, utilizing keywords such as "diabetes", "diabetes mellitus", "diabetes complications". Results The number of people with diabetes has continued to rise. Scientists predict that in a few decades, this number could reach more than half a billion globally. Many individuals may not realize that they are at risk for this civilization disease, often due to unhealthy lifestyle choices such as smoking, obesity, and lack of physical activity. Early initiation of treatment is crucial in preventing serious complications. Despite living with diabetes for years, some patients still report insufficient knowledge about their condition. Therefore, educating patients about the nature of the disease and its treatment is essential for improving their quality of life.

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“…Several GLP-1 RAs, including liraglutide, semaglutide, and dulaglutide, have little renal clearance and are safe to use even in patients with advanced-stage DKD [164]. GLP-1 receptor agonists appeared to be effective in reducing the risk of cardiovascular mortality, myocardial infarction, and stroke [165]. However, the addition of a GLP-1 analogue should be considered in patients with a contraindication or intolerance to metformin, in patients with a haemoglobin A1c greater than 1.5% over target, or in patients who do not reach their target A1c in three months, particularly in patients with atherosclerosis, heart failure, or chronic kidney disease [166].…”

Section: Glucagon-like Peptide-1 Receptor Agonistmentioning

confidence: 99%

Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions

Jha,

Lopez-Trevino,

Kankanamalage

et al. 2024

Biomedicines

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Diabetic kidney disease (DKD) is a major microvascular complication of both type 1 and type 2 diabetes. DKD is characterised by injury to both glomerular and tubular compartments, leading to kidney dysfunction over time. It is one of the most common causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Persistent high blood glucose levels can damage the small blood vessels in the kidneys, impairing their ability to filter waste and fluids from the blood effectively. Other factors like high blood pressure (hypertension), genetics, and lifestyle habits can also contribute to the development and progression of DKD. The key features of renal complications of diabetes include morphological and functional alterations to renal glomeruli and tubules leading to mesangial expansion, glomerulosclerosis, homogenous thickening of the glomerular basement membrane (GBM), albuminuria, tubulointerstitial fibrosis and progressive decline in renal function. In advanced stages, DKD may require treatments such as dialysis or kidney transplant to sustain life. Therefore, early detection and proactive management of diabetes and its complications are crucial in preventing DKD and preserving kidney function.

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Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Cardiovascular Risk Management in Patients With Type 2 Diabetes Mellitus: A Systematic Review

Cited by 7 publications

References 33 publications

Efficacy and safety of polyethylene glycol loxenatide in treating mild-to-moderate diabetic kidney disease in type 2 diabetes patients: a randomized, open-label, clinical trial

Efficacy and safety of polyethylene glycol loxenatide in treating mild-to-moderate diabetic kidney disease in type 2 diabetes patients: a randomized, open-label, clinical trial

Classification, Symptoms, Treatment and Preventive Strategies of Diabetes. A guide to the basic

Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions

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