The effect of dulaglutide on body composition in type 2 diabetes mellitus patients on hemodialysis

J Diabetes Complications. 2018 Aug;32(8):759-763. doi: 10.1016/j.jdiacomp.2018.05.018. Epub 2018 Jun 1.

Abstract

Aims: To evaluate the effect of dulaglutide on body composition in type 2 diabetes mellitus (T2DM) patients undergoing hemodialysis (HD).

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Dulaglutide; Hemodialysis; Sarcopenia; Skeletal muscle mass; Teneligliptin; Type 2 diabetes mellitus.

MeSH terms

  • Aged
  • Body Composition / drug effects*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / therapy
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / metabolism
  • Diabetic Nephropathies / therapy*
  • Female
  • Glucagon-Like Peptides / analogs & derivatives*
  • Glucagon-Like Peptides / therapeutic use
  • Humans
  • Immunoglobulin Fc Fragments / therapeutic use*
  • Male
  • Middle Aged
  • Pyrazoles / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use*
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / metabolism
  • Renal Insufficiency, Chronic / therapy*
  • Sarcopenia / etiology
  • Thiazolidines / therapeutic use

Substances

  • 3-(4-(4-(3-methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl)pyrrolidin-2-ylcarbonyl)thiazolidine
  • Immunoglobulin Fc Fragments
  • Pyrazoles
  • Recombinant Fusion Proteins
  • Thiazolidines
  • Glucagon-Like Peptides
  • dulaglutide