The Administration of Xultophy for Diabetic Patients on Hemodialysis

Fujikawa T¹, Kato Y¹, Bando H^1,2*, Kakutani H¹, Kawata T¹, Yamamoto M¹, Wada K¹, Ishikura K¹, Shirai Y¹, Narutaki M¹, Matsuzaki S¹, Waka S^1
1Kanaiso Hospital, Tokushima, Japan
²Tokushima University / Medical Research, Tokushima, Japan

Corresponding Author: Hiroshi BANDO, MD, PhD, FACP ORCID ID Address: Tokushima University /Medical Research, Nakashowa 1-61, Tokushima 770-0943 Japan.
Received date: 14 September 2020; Accepted date: 10 October 2020; Published date: 20 October 2020

Citation: Fujikawa T, Kato Y, Bando H, Kakutani H, Kawata T, Yamamoto M, Wada K, Ishikura K, Shirai Y, Narutaki M, Matsuzaki S, Waka S. The Administration of Xultophy for Diabetic Patients on Hemodialysis. Diab Res Open Access. 2020 Oct 20;2(3):72-78.

Copyright © 2020 Fujikawa T, Kato Y, Bando H, Kakutani H, Kawata T, Yamamoto M, Wada K, Ishikura K, Shirai Y, Narutaki M, Matsuzaki S, Waka S. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: Xultophy, Insulin Degludec/Liraglutide (IDegLira), Type 2 Diabetes Mellitus, Hemodialysis

Abbreviation: OHAs: Oral Hypoglycemic Agents; ASCVD: Atherosclerotic Cardiovascular Disease; GLP-1 RA: Glucagon-Like Protein-1 Receptor Agonist; T2DM: Type 2 Diabetes Mellitus; JLCDPA: Japan LCD Promotion Association

Abstract

Background: Recent diabetic treatments include Insulin Degludec/ liraglutide (IDeg/Lira, Xultophy) in clinical practice. Authors have continued clinical research concerning diabetes, chronic renal failure, dialysis, and others.
Subjects and Methods: Ten patients with type 2 diabetes mellitus (T2DM) undergoing hemodialysis were investigated. They showed that ages 74.5 ± 5.9 years, M/F=6/4, BMI 21.1± 3.8kg/m², hemodialysis duration 8.1 ± 5.7 years. At the beginning, fundamental data were Cre 8.2 ± 1.9 mg/dL, HbA1c 6.5 ± 0.8%. Xultophy was started on 5-12 doses and continued for 6 months with the same or 1-4 increased doses for better glycemic variability.
Results: Out of 10 subjects, the changes in HbA1c showed a decrease in 7, stable in 2, and an increase in 1. HbA1c value was 6.2 ± 0.8% in average at 6 months. There were no remarkable adverse effects by Xultophy for 6 months.
Discussion and Conclusion: Xultophy was started at 5-12 doses, which were remarkably lower doses than usual doses with satisfactory efficacy. One of the reasons may be from the characteristic of the patients, who were diabetic with undergoing hemodialysis. Another factor is possibly from liraglutide, which has hepatic clearance with potential vascular protective effects. These results are expected to become reference data for future research.