769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial
GLP1 RAs are first line drugs for DM2, due to their effects on glycemic control, cardiorenal protection and weight-loss action. However, consistent data about efficacy and safety in patients with liver transplant (LT) are lacking. Aim: to assess the efficacy and safety of GLP1RAs in people with LT a...
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| Veröffentlicht in: | Diabetes (New York, N.Y.) N.Y.), 2024-06, Vol.73, p.1 |
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| creator | Grancini, Valeria Cogliati, Irene Gaglio, Alessia Resi, Veronica Orsi, Emanuela |
| description | GLP1 RAs are first line drugs for DM2, due to their effects on glycemic control, cardiorenal protection and weight-loss action. However, consistent data about efficacy and safety in patients with liver transplant (LT) are lacking. Aim: to assess the efficacy and safety of GLP1RAs in people with LT and diabetes in a period of 24 months. Methods: 52 patients with DM and LT, were enrolled: follow up visits were planned 6-12-24 months after starting a GLP1RA-based therapy (dulaglutide or injectable semaglutide), as add on to metformin or insulin. We assessed glycemic control, body weight and composition (with bio-impedance analysis), liver fibrosis and steatosis (with transient elastography). Amylase, lipase levels and concomitant therapies were recorded at all visits. Patients had an e-mail contact to report any adverse events (AE). At the ad interim analysis, all patients enrolled underwent the first follow up visit, 29 patients completed the study. Results: We observed a decrease in blood glucose (BG - 8.0±2.2 to 6.8±1.45 to 7.4±1.7mmol/L) and HbA1c (7.1±0.9 to 6.5±1.0 to 6.4±0.6%), p 3 times the normal values. Of them, all suffered from biliary strictures). At the short-term follow up, we already observed the improvement in BG and HbA1c (p |
| doi_str_mv | 10.2337/db24-769-P |
| format | Article |
| fullrecord | <record><control><sourceid>proquest</sourceid><recordid>TN_cdi_proquest_journals_3111275522</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3111275522</sourcerecordid><originalsourceid>FETCH-proquest_journals_31112755223</originalsourceid><addsrcrecordid>eNqNjstKAzEYhUNR6Kjd9Al-cB3NxTaMu6L1AhWGOgt3Je38wZSYjEnG0rc3ig8gZ3EW38fhEDLl7EpIqa67rbihal7TZkQqXsuaSqHeTkjFGBeUq1qNyVlKe8bYvKQih1_5FpbG2J3eHUH7Dl61wXyEYOBx1fD1IoH1sLJfGGkbtU-90z5jBw2G3iEcbH6He6u3mDHRRQfPhUb7AWtMg8vpZ0hDOfYSfDHbaLW7IKdGu4STvz4nlw_L9u6J9jF8DpjyZh-G6AvaSM65ULOZEPJ_1jdd7k9W</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3111275522</pqid></control><display><type>article</type><title>769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial</title><source>EZB-FREE-00999 freely available EZB journals</source><creator>Grancini, Valeria ; Cogliati, Irene ; Gaglio, Alessia ; Resi, Veronica ; Orsi, Emanuela</creator><creatorcontrib>Grancini, Valeria ; Cogliati, Irene ; Gaglio, Alessia ; Resi, Veronica ; Orsi, Emanuela</creatorcontrib><description>GLP1 RAs are first line drugs for DM2, due to their effects on glycemic control, cardiorenal protection and weight-loss action. However, consistent data about efficacy and safety in patients with liver transplant (LT) are lacking. Aim: to assess the efficacy and safety of GLP1RAs in people with LT and diabetes in a period of 24 months. Methods: 52 patients with DM and LT, were enrolled: follow up visits were planned 6-12-24 months after starting a GLP1RA-based therapy (dulaglutide or injectable semaglutide), as add on to metformin or insulin. We assessed glycemic control, body weight and composition (with bio-impedance analysis), liver fibrosis and steatosis (with transient elastography). Amylase, lipase levels and concomitant therapies were recorded at all visits. Patients had an e-mail contact to report any adverse events (AE). At the ad interim analysis, all patients enrolled underwent the first follow up visit, 29 patients completed the study. Results: We observed a decrease in blood glucose (BG - 8.0±2.2 to 6.8±1.45 to 7.4±1.7mmol/L) and HbA1c (7.1±0.9 to 6.5±1.0 to 6.4±0.6%), p<0.01. BMI, fat mass e fat free mass showed a slight, non significative, improvement. We found no changes in data from elastography. 3 patients interrupted the treatment due to major AE (2 had pancreatitis 8 and 12 month from baseline, 1 had an increase of lipase > 3 times the normal values. Of them, all suffered from biliary strictures). At the short-term follow up, we already observed the improvement in BG and HbA1c (p<0.01), amylase and lipase didn't increase significantly. 14 people (26.9%) reported mild nausea, but only 3 patients (5.8%) reduced the drug dose. Among 30 patients requiring insulin at enrollment, 15 (50%) and 5 (16.6%), respectively, reduced or suspended insulin therapy in the first 6 months. Conclusions: GLP1RAs can be considered effective in patients with LT. Further studies are needed to assess if post-surgery biliary strictures could be a potential contraindication to their use.</description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/db24-769-P</identifier><language>eng</language><publisher>New York: American Diabetes Association</publisher><subject>Body fat ; Diabetes ; Diabetes mellitus ; Fatty liver ; Fibrosis ; Insulin ; Lipase ; Liver transplantation ; Metformin ; Pancreatitis ; Patients ; Steatosis ; Stricture</subject><ispartof>Diabetes (New York, N.Y.), 2024-06, Vol.73, p.1</ispartof><rights>Copyright American Diabetes Association Jun 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids></links><search><creatorcontrib>Grancini, Valeria</creatorcontrib><creatorcontrib>Cogliati, Irene</creatorcontrib><creatorcontrib>Gaglio, Alessia</creatorcontrib><creatorcontrib>Resi, Veronica</creatorcontrib><creatorcontrib>Orsi, Emanuela</creatorcontrib><title>769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial</title><title>Diabetes (New York, N.Y.)</title><description>GLP1 RAs are first line drugs for DM2, due to their effects on glycemic control, cardiorenal protection and weight-loss action. However, consistent data about efficacy and safety in patients with liver transplant (LT) are lacking. Aim: to assess the efficacy and safety of GLP1RAs in people with LT and diabetes in a period of 24 months. Methods: 52 patients with DM and LT, were enrolled: follow up visits were planned 6-12-24 months after starting a GLP1RA-based therapy (dulaglutide or injectable semaglutide), as add on to metformin or insulin. We assessed glycemic control, body weight and composition (with bio-impedance analysis), liver fibrosis and steatosis (with transient elastography). Amylase, lipase levels and concomitant therapies were recorded at all visits. Patients had an e-mail contact to report any adverse events (AE). At the ad interim analysis, all patients enrolled underwent the first follow up visit, 29 patients completed the study. Results: We observed a decrease in blood glucose (BG - 8.0±2.2 to 6.8±1.45 to 7.4±1.7mmol/L) and HbA1c (7.1±0.9 to 6.5±1.0 to 6.4±0.6%), p<0.01. BMI, fat mass e fat free mass showed a slight, non significative, improvement. We found no changes in data from elastography. 3 patients interrupted the treatment due to major AE (2 had pancreatitis 8 and 12 month from baseline, 1 had an increase of lipase > 3 times the normal values. Of them, all suffered from biliary strictures). At the short-term follow up, we already observed the improvement in BG and HbA1c (p<0.01), amylase and lipase didn't increase significantly. 14 people (26.9%) reported mild nausea, but only 3 patients (5.8%) reduced the drug dose. Among 30 patients requiring insulin at enrollment, 15 (50%) and 5 (16.6%), respectively, reduced or suspended insulin therapy in the first 6 months. Conclusions: GLP1RAs can be considered effective in patients with LT. Further studies are needed to assess if post-surgery biliary strictures could be a potential contraindication to their use.</description><subject>Body fat</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Fatty liver</subject><subject>Fibrosis</subject><subject>Insulin</subject><subject>Lipase</subject><subject>Liver transplantation</subject><subject>Metformin</subject><subject>Pancreatitis</subject><subject>Patients</subject><subject>Steatosis</subject><subject>Stricture</subject><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqNjstKAzEYhUNR6Kjd9Al-cB3NxTaMu6L1AhWGOgt3Je38wZSYjEnG0rc3ig8gZ3EW38fhEDLl7EpIqa67rbihal7TZkQqXsuaSqHeTkjFGBeUq1qNyVlKe8bYvKQih1_5FpbG2J3eHUH7Dl61wXyEYOBx1fD1IoH1sLJfGGkbtU-90z5jBw2G3iEcbH6He6u3mDHRRQfPhUb7AWtMg8vpZ0hDOfYSfDHbaLW7IKdGu4STvz4nlw_L9u6J9jF8DpjyZh-G6AvaSM65ULOZEPJ_1jdd7k9W</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Grancini, Valeria</creator><creator>Cogliati, Irene</creator><creator>Gaglio, Alessia</creator><creator>Resi, Veronica</creator><creator>Orsi, Emanuela</creator><general>American Diabetes Association</general><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20240601</creationdate><title>769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial</title><author>Grancini, Valeria ; Cogliati, Irene ; Gaglio, Alessia ; Resi, Veronica ; Orsi, Emanuela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_journals_31112755223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Body fat</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Fatty liver</topic><topic>Fibrosis</topic><topic>Insulin</topic><topic>Lipase</topic><topic>Liver transplantation</topic><topic>Metformin</topic><topic>Pancreatitis</topic><topic>Patients</topic><topic>Steatosis</topic><topic>Stricture</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grancini, Valeria</creatorcontrib><creatorcontrib>Cogliati, Irene</creatorcontrib><creatorcontrib>Gaglio, Alessia</creatorcontrib><creatorcontrib>Resi, Veronica</creatorcontrib><creatorcontrib>Orsi, Emanuela</creatorcontrib><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grancini, Valeria</au><au>Cogliati, Irene</au><au>Gaglio, Alessia</au><au>Resi, Veronica</au><au>Orsi, Emanuela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><date>2024-06-01</date><risdate>2024</risdate><volume>73</volume><spage>1</spage><pages>1-</pages><issn>0012-1797</issn><eissn>1939-327X</eissn><abstract>GLP1 RAs are first line drugs for DM2, due to their effects on glycemic control, cardiorenal protection and weight-loss action. However, consistent data about efficacy and safety in patients with liver transplant (LT) are lacking. Aim: to assess the efficacy and safety of GLP1RAs in people with LT and diabetes in a period of 24 months. Methods: 52 patients with DM and LT, were enrolled: follow up visits were planned 6-12-24 months after starting a GLP1RA-based therapy (dulaglutide or injectable semaglutide), as add on to metformin or insulin. We assessed glycemic control, body weight and composition (with bio-impedance analysis), liver fibrosis and steatosis (with transient elastography). Amylase, lipase levels and concomitant therapies were recorded at all visits. Patients had an e-mail contact to report any adverse events (AE). At the ad interim analysis, all patients enrolled underwent the first follow up visit, 29 patients completed the study. Results: We observed a decrease in blood glucose (BG - 8.0±2.2 to 6.8±1.45 to 7.4±1.7mmol/L) and HbA1c (7.1±0.9 to 6.5±1.0 to 6.4±0.6%), p<0.01. BMI, fat mass e fat free mass showed a slight, non significative, improvement. We found no changes in data from elastography. 3 patients interrupted the treatment due to major AE (2 had pancreatitis 8 and 12 month from baseline, 1 had an increase of lipase > 3 times the normal values. Of them, all suffered from biliary strictures). At the short-term follow up, we already observed the improvement in BG and HbA1c (p<0.01), amylase and lipase didn't increase significantly. 14 people (26.9%) reported mild nausea, but only 3 patients (5.8%) reduced the drug dose. Among 30 patients requiring insulin at enrollment, 15 (50%) and 5 (16.6%), respectively, reduced or suspended insulin therapy in the first 6 months. Conclusions: GLP1RAs can be considered effective in patients with LT. Further studies are needed to assess if post-surgery biliary strictures could be a potential contraindication to their use.</abstract><cop>New York</cop><pub>American Diabetes Association</pub><doi>10.2337/db24-769-P</doi></addata></record> |
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| source | EZB-FREE-00999 freely available EZB journals |
| subjects | Body fat Diabetes Diabetes mellitus Fatty liver Fibrosis Insulin Lipase Liver transplantation Metformin Pancreatitis Patients Steatosis Stricture |
| title | 769-P: Efficacy and Safety of GLP1RAs in Liver-Transplanted People with Diabetes-Ad Interim Results of a 24-Month Trial |
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