Department of Nephrology, Matsunami General Hospital, Gifu 501-6062, Japan.
Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan.
J Diabetes Complications. 2018 Aug;32(8):759-763. doi: 10.1016/j.jdiacomp.2018.05.018. Epub 2018 Jun 1.
To evaluate the effect of dulaglutide on body composition in type 2 diabetes mellitus (T2DM) patients undergoing hemodialysis (HD).
Twenty-one T2DM patients on HD, who had been treated with insulin and newly added teneligliptin (N = 10) or dulaglutide (N = 11), were enrolled. Body composition changes, such as fat mass (FM) and skeletal muscle mass (SMM), glycated albumin (GA), and insulin doses were compared before and after six months of treatment with teneligliptin or dulaglutide.
The percentage changes of GA and insulin doses were comparable between the teneliglipin and dulaglutide groups. Conversely, although FM and SMM did not change in the teneligliptin group (from 15.7 kg to 14.1 kg, P = 0.63 and 18.6 kg to 18.9 kg, P = 0.16, respectively), those in the dulaglutide group significantly decreased (from 21.9 kg to 18.9 kg, P = 0.037 and 21.0 kg to 20.2 kg, P = 0.011, respectively).
Six months of dulaglutide treatment significantly reduced not only FM but also SMM, although changes in GA and insulin doses were comparable with those in the teneligliptin group. Dulaglutide may have the effect of promoting sarcopenia; therefore, it may be carefully used in T2DM patients on HD.
评估度拉糖肽对接受血液透析(HD)的 2 型糖尿病(T2DM)患者体成分的影响。
共纳入 21 例正在接受胰岛素治疗且新添加替格列汀(N=10)或度拉糖肽(N=11)的 HD 治疗的 T2DM 患者。比较了替格列汀或度拉糖肽治疗 6 个月前后体成分变化(如脂肪量 [FM] 和骨骼肌量 [SMM]、糖化白蛋白 [GA] 和胰岛素剂量)。
替格列汀组和度拉糖肽组的 GA 和胰岛素剂量的百分比变化相当。相反,替格列汀组的 FM 和 SMM 没有变化(从 15.7kg 降至 14.1kg,P=0.63 和从 18.6kg 降至 18.9kg,P=0.16),而度拉糖肽组则显著下降(从 21.9kg 降至 18.9kg,P=0.037 和从 21.0kg 降至 20.2kg,P=0.011)。
虽然替格列汀组和度拉糖肽组的 GA 和胰岛素剂量变化相当,但度拉糖肽治疗 6 个月不仅可显著降低 FM,还可降低 SMM。度拉糖肽可能具有促进肌少症的作用;因此,在 HD 治疗的 T2DM 患者中应谨慎使用。