After 12 months of treatment with subcutaneous semaglutide, 57% of patients with type 2 diabetes and achieved levels below 7%.
A mean reduction in glycosylated hemoglobin A1c of -0.73% was observed (P < .001).
Weight loss averaged -6.95 kg, with 59% of patients losing more than 5% of their body weight (P < .001).
Systolic and diastolic blood pressure decreased by -9.85 mmHg and -5.92 mmHg, respectively (P < .001).
In patients with baseline macroalbuminuria, the mean urinary albumin:creatinine ratio decreased by 51%.
The mean estimated glomerular filtration rate remained stable throughout the study.
The need for basal insulin decreased by 20% (P < .005), with only 7% of insulin-treated patients experiencing mild hypoglycemic episodes.
Simplified
BACKGROUND: Semaglutide [glucagon-like peptide-1 receptor-agonist (GLP-1RA)] has shown nephroprotective effects in previous cardiovascular studies. However, its efficacy and safety in patients with (CKD) and type 2 diabetes (T2D) have been rarely studied.
METHODS: This is a multicenter, retrospective, observational study in patients with T2D and CKD with (HbA1c) of 7.5-9.5% treated with subcutaneous semaglutide for 12 months in real-world clinical practice. The main objectives were glycemic control as HbA1c <7% and weight loss >5%.
RESULTS: We studied a total of 122 patients, ages 65.50 ± 11 years, 62% men, duration of T2D 12 years, baseline HbA1c 7.57% ± 1.36% and an estimated glomerular filtration rate (eGFR) 50.32 ± 19.21 mL/min/1.73 m; 54% had a urinary albumin:creatinine ratio (UACR) of 30-300 mg/g and 20% had a UACR >300 mg/g. After 12 months of follow-up, HbA1c declined -0.73% ± 1.09% (P < .001), with 57% of patients achieving values <7% and weight loss of -6.95 kg (P < .001), with 59% of patients showing a reduction of >5% of their body weight. Systolic and diastolic blood pressure decreased -9.85 mmHg and -5.92 mmHg, respectively (P < .001). The mean UACR decreased 51% in the group with baseline macroalbuminuria (UACR >300 mg/g). The mean eGFR (by the Chronic Kidney Disease Epidemiology Collaboration) remained stable. The need for basal insulin decreased 20% (P < .005). Only 7% of patients on insulin had mild hypoglycemic episodes. Semaglutide was stopped in 5.7% of patients for digestive intolerance. 2
CONCLUSIONS: In this real-world study, patients with T2D and CKD treated with subcutaneous semaglutide for 12 months significantly improved glycemic control and decreased weight. Albuminuria decreased by >50% in patients with macroalbuminuria. The administration of GLP-1RA in patients with T2D and CKD was safe and well tolerated.
Key numbers
-0.73%
Decrease
From baseline of 7.57% to 6.83% after 12 months.
-6.95 kg
Weight Loss
Average weight change over 12 months.
51%
UACR Reduction
Mean decrease in UACR for patients with baseline macroalbuminuria.
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