Clinical cases of management of patients with type 2 diabetes mellitus using GLP-1 receptor agonists

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In recent years, many medical studies and programs have been aimed at the multifactorial treatment of type 2 diabetes mellitus (DM2), which not only includes achieving target blood glucose values, but also has cardio-nephroprotective properties to reduce the risk of remote macro- and microvascular complications, and also has a positive effect on body weight. A significant breakthrough in the solution of DM2 control and management was the fundamental discovery of a new class of hypoglycemic drugs: prolonged and highly homologous of glucagon-like peptide-1 receptor agonists (GLP-1 RA) – semaglutide, based on this class of the generally recognized drug liraglutide. This article provides 2 clinical examples of the use of domestic semaglutide (Semavik). The first clinical case describes a 62-year-old patient with grade 3 abdominal-constitutional obesity, a long history of DM2, receiving combination therapy (insulin glargine + sodium glucose cotransporter inhibitor type 2 + metformin). The second clinical case presents a patient with newly diagnosed type 2 diabetes and obesity, for whom therapy with domestic GLP-1RA as first-line therapy was initiated. The patients underwent an examination that allowed the use of GLP-1 RA, the dynamics of blood glucose normalization, improvement of lipid profile indicators, and weight loss were shown. These clinical cases are an example of the possibility of using modern drugs, in particular, domestic semaglutide as monotherapy and combination therapy with subsequent insulin withdrawal. The use of modern drugs allows to achieve target glycemic indicators, prevent the development of cardiovascular complications and improve life prognosis in a greater number of cases.

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Sobre autores

N. Kanavets

Saint Petersburg State Pediatric University

Autor responsável pela correspondência
Email: natalia.kanavets@mail.ru
ORCID ID: 0000-0003-4693-4338
Código SPIN: 1652-8330

Cand. Sci. (Med.)

Rússia, Saint Petersburg

D. Rebrova

Saint Petersburg State University

Email: natalia.kanavets@mail.ru
ORCID ID: 0000-0002-7840-4174
Código SPIN: 6284-9008
Scopus Author ID: 57195152806
Researcher ID: AHD-5099-2022
Rússia, Saint Petersburg

Bibliografia

  1. IDF Diabetes Atlas 10th Edition 2021. URL: https://diabetesatlas.org/atlas/tenth-edition.
  2. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 11-й выпуск. М., 2023. [Algorithms of specialized medical care for patients with diabetes mellitus. Edited by I.I. Dedov, M.V. Shestakova, A.Yu. Mayorov. 11th issue. Moscow, 2023. (In Russ.)]. doi: 10.14341/DM13042.
  3. Davies M.J., Aroda V.R., Collins B.S., et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65:1925–66. doi: 10.1007/s00125-022-05787-2.
  4. Marso S.P., Bain S.C., Consoli A., et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834–44. doi: 10.1056/NEJMoa1607141.
  5. Rossing P., Baeres F.M.M., Bakris G., et al. The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease. Nephrol Dial Transplant. 2023;38(9):2041–51. doi: 10.1093/ndt/gfad009.
  6. Tsapas A., Avgerinos I., Karagiannis T., et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes. Ann Intern Med. 2020;173:278–86. doi: 10.7326/M20-0864.
  7. Tsapas A., Karagiannis T., Kakotrichi P., et al. Comparative efficacy of glucose-lowering medications on body weight and blood pressure in patients with type 2 diabetes: A systematic review and network meta-analysis. Diab Obes.Metab. 2021;23(9):2116–24. doi: 10.1111/dom.14451.
  8. Nauck M. Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diab. Obes. Metab. 2016;18(3):203–16. doi: 10.1111/dom.12591.
  9. Aroda V.R. A review of GLP-1 receptor agonists: evolution and advancement, through the lens of randomised controlled trials. Diab Obes Metab. 2018;20(Suppl. 1):22–33. doi: 10.1111/dom.13162.
  10. Htike Z.Z., Zaccardi F., Papamargaritis D., et al. Efficacy and safety of glucagon-like peptide-1 receptor agonists in type 2 diabetes: a systematic review and mixed-treatment comparison analysis. Diab Obes Metab. 2017;19(4):524–36. doi: 10.1111/dom.12849.
  11. Lau J., Bloch P., Schaffer L., et al. Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide. J Med Chem. 2015;58(18):7370–80. doi: 10.1021/acs.jmedchem.5b00726.
  12. Cornell S. A review of GLP-1 receptor agonists in type 2 diabetes: a focus on the mechanism of action of once-weekly agents. J Clin Pharm Ther. 2020;45(Suppl. 1):17–27. doi: 10.1111/jcpt.13230.
  13. Almandoz J.P., Lingvay I., Morales J., Campos C. Switching between glucagon-like peptide-1 receptor agonists: rationale and practical guidance. Clin Diab. 2020;38(4):390–402. doi: 10.2337/cd19-0100.
  14. Draznin B., Aroda V.R., Bakris G., et al. American Diabetes Association Professional Practice Committee, 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2022. Diab Care. 2022;45(Suppl._1):S125–43. 10.2337/dc22-S009.
  15. American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes-2022. Diab Care. 2022;45(Suppl._1):S144–74. 10.2337/dc22-S010.
  16. Garber A.J., Handelsman Y., Grunberger G., et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary. Endocr Pract. 2020;26(1):107–39. doi: 10.4158/CS-2019-0472.
  17. Демидова Т.Ю., Ушанова Ф.О., Богачева Т.Л. Семаглутид в терапии СД 2 типа: обзор накопленных данных от идеи создания до настоящего времени. FOCUS Эндокринология. 2023;4(3):13–28. [Demidova T.Yu., Ushanova F.O., Bogacheva T.L. Semaglutide in type 2 diabetes management: review of current evidence from concept to date. FOCUS Endocrinology. 2023;4(3):13–28. (In Russ.)]. doi: 10.15829/2713-0177-2023-3-11.

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3. Fig. 2. Photo of Patient S., 36 years old

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