682-P: Early Detection and Prevention of Dulaglutide-Induced Asymptomatic Nocturnal and Persistent Hypoglycemia in Patients with Advanced Diabetic Kidney Disease

Purpose: Dulaglutide, a long acting GLP-1 receptor agonist (GLP-1 RA) is reported to reduce decline in eGFR in patients with diabetic kidney disease (DKD). Dulaglutide has been applied to the treatment and prevention of advanced DKD. GLP-1RA is well known to suppress glucagon secretion from the pancreas. In advanced DKD, renal gluconeogenesis is reduced due to the progression of DKD, and thereby the incidence of hypoglycemia is increased in advanced DKD. However, hypoglycemia due to GLP-1RA is rarely reported in advanced DKD. The present study was performed in order to get further insight into the risk management of hypoglycemia in advanced DKD patients treated with GLP-RA using continuous glucose monitoring (CGM). Methods: Eleven patients with advanced DKD (eGFR