Otsuka Emiko, Kitamura Mineaki, Funakoshi Satoshi, Mukae Hiroshi, Nishino Tomoya
Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Nagasaki Renal Center, Nagasaki, Japan.
Front Pharmacol. 2024 May 30;15:1362242. doi: 10.3389/fphar.2024.1362242. eCollection 2024.
Tirzepatide-a dual glucose-dependent insulinotropic peptide and glucagon-like peptide-1 receptor agonist-is used to treat type 2 diabetes. However, the efficacy and safety of tirzepatide in patients undergoing hemodialysis remain unclear. We conducted a single-center retrospective study of patients with type 2 diabetes undergoing hemodialysis who were transitioned from dulaglutide to tirzepatide. We continuously monitored glucose levels in patients undergoing hemodialysis before and after switching from dulaglutide to tirzepatide. Fourteen patients (mean age: 61.9 ± 9.9 years, male: female = 11:3) were included in this study. After switching to tirzepatide, time in range increased to 50.8% from 42.7% ( = 0.02), time above range decreased to 37.8% from 48.4% ( = 0.02), and mean glucose levels decreased to 137.4 mg/dL from 156.6 mg/dL ( = 0.006). In contrast, there was no significant difference in time below range before and after tirzepatide administration (11.3% and 8.9%) ( = 0.75). Three patients experienced dyspepsia (21.4%), and one patient experienced nausea (7.1%); however, no critical adverse events were reported. Transitioning from dulaglutide to tirzepatide improved glycemic control without increasing hypoglycemia in patients undergoing hemodialysis for type 2 diabetes.
替尔泊肽——一种双重葡萄糖依赖性促胰岛素多肽和胰高血糖素样肽-1受体激动剂——用于治疗2型糖尿病。然而，替尔泊肽在接受血液透析的患者中的疗效和安全性仍不明确。我们对从度拉糖肽转换为替尔泊肽的接受血液透析的2型糖尿病患者进行了一项单中心回顾性研究。我们持续监测了从度拉糖肽转换为替尔泊肽前后接受血液透析患者的血糖水平。本研究纳入了14例患者（平均年龄：61.9±9.9岁，男性:女性=11:3）。转换为替尔泊肽后，血糖在目标范围内的时间从42.7%增加到50.8%（P=0.02），高于目标范围的时间从48.4%降至37.8%（P=0.02），平均血糖水平从156.6mg/dL降至137.4mg/dL（P=0.006）。相比之下，替尔泊肽给药前后血糖低于目标范围的时间无显著差异（分别为11.3%和8.9%）（P=0.75）。3例患者出现消化不良（21.4%），1例患者出现恶心（7.1%）；然而，未报告严重不良事件。从度拉糖肽转换为替尔泊肽可改善2型糖尿病血液透析患者的血糖控制，且不会增加低血糖风险。
