Diabetes Research: Open Access
Article Type: Original Article
Diab Res Open Access. 2020 Oct 20;2(3):72-78
Fujikawa T1, Kato Y1, Bando H1,2*, Kakutani H1, Kawata T1, Yamamoto M1, Wada K1, Ishikura K1, Shirai Y1, Narutaki M1, Matsuzaki S1, Waka S1
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
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.