GLP-1 Receptor Agonists and SGLT-2 Inhibitors in Diabetic Nephropathy: A Comparative Study.
To investigate the effects of glucagon-like peptide-1 receptor agonist (GLP-1RAs) on renal function in type 2 diabetes mellitus (T2DM) patients and compared their efficacy to sodium-glucose co-transporter-2 inhibitors (SGLT-2i) in managing diabetic nephropathy.
This is a retrospective cohort study conducted at King Fahad University Hospital, including 115 adults (≥18 years) with T2DM and baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73m2, treated with GLP-1RAs or SGLT-2i for over 1 year. Patients on renal replacement therapy, nephrotoxic drugs, or with incomplete records were excluded. Data were analyzed with Jeffrey's Amazing Statistics Program; the significant value is p < 0.05.
Participants were treated with either SGLT-2i (67.8%) or GLP-1RAs (32.2%). Both groups showed minimal improvements in glycemic control, hemoglobin A1c decreased from 7.86% to 7.66% (SGLT-2i) and from 8% to 7.76% (GLP-1RAs). Estimated GFR minimally improved by 0.5-1.2 mL/min/1.73m2 (GLP-1RAs) and changed by -1.2 to +10.1 mL/min/1.73m2 (SGLT-2i). Urine albumin/creatinine ratio dropped by 13.35 mg/g with GLP-1RAs but increased by 49.86 mg/g with SGLT-2i.
Both medications offered comparable glycemic and renal benefits. The GLP-1RAs, however, demonstrated more favorable effects on albuminuria, suggesting potential for superior renal protection in nascent diabetic nephropathy.
This is a retrospective cohort study conducted at King Fahad University Hospital, including 115 adults (≥18 years) with T2DM and baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73m2, treated with GLP-1RAs or SGLT-2i for over 1 year. Patients on renal replacement therapy, nephrotoxic drugs, or with incomplete records were excluded. Data were analyzed with Jeffrey's Amazing Statistics Program; the significant value is p < 0.05.
Participants were treated with either SGLT-2i (67.8%) or GLP-1RAs (32.2%). Both groups showed minimal improvements in glycemic control, hemoglobin A1c decreased from 7.86% to 7.66% (SGLT-2i) and from 8% to 7.76% (GLP-1RAs). Estimated GFR minimally improved by 0.5-1.2 mL/min/1.73m2 (GLP-1RAs) and changed by -1.2 to +10.1 mL/min/1.73m2 (SGLT-2i). Urine albumin/creatinine ratio dropped by 13.35 mg/g with GLP-1RAs but increased by 49.86 mg/g with SGLT-2i.
Both medications offered comparable glycemic and renal benefits. The GLP-1RAs, however, demonstrated more favorable effects on albuminuria, suggesting potential for superior renal protection in nascent diabetic nephropathy.
Authors
Alghadeer Alghadeer, Kanfar Kanfar, Algallaf Algallaf, Alfardan Alfardan, Alshammrany Alshammrany, Farhat Farhat, Cyrus Cyrus
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