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Kidney transplant recipients with kind 2 diabetes handled with a brand new class of anti-obesity medicine had been much less prone to expertise organ failure and survived longer, a brand new examine reveals. Not solely is weight problems a recognized threat issue for diabetes, however it additionally will increase threat of postsurgical problems, akin to irritation, organ rejection, and early demise.
The analysis has been revealed within the journal The Lancet Diabetes and Endocrinology.
Earlier analysis had prompt some profit for kidney transplant recipients with a historical past of kind 2 diabetes who took the medicines, initially designed to deal with diabetes, in some unspecified time in the future after their transplant after which skilled slower declines in kidney perform than those that didn’t.
These GLP-1 agonists embrace semaglutide, liraglutide, and dulaglutide, now marketed as Ozempic, Wegovy, Saxenda, Victoza, and Trulicity.
It remained unclear, nonetheless, whether or not physicians ought to prescribe the medicine, given their recognized negative effects, which embrace irritation within the pancreas and liver issues.
There had additionally been concern that GLP-1 agonists may enhance the danger for a uncommon type of thyroid most cancers in sufferers already taking immune-suppressing medicine to forestall transplant rejection, a situation the place the physique’s immune system assaults the transplanted kidney as it might a international virus or micro organism.
Led by researchers at NYU Langone Well being, the brand new examine confirmed that those that had been prescribed GLP-1 agonists, principally inside three years of receiving their transplant, had been 49% much less prone to expertise organ failure—when the transplanted kidney stops functioning, and the affected person has to renew dialysis—than those that had not been prescribed a GLP-1.
Kidney transplant recipients taking the medicines additionally had a 31% lowered threat of dying inside 5 years of their beginning on the medicine, in comparison with those that didn’t take the medicine.
Whereas threat for irritation within the pancreas, liver issues, or thyroid most cancers was not discovered to be greater in sufferers with diabetes handled with GLP-1s, the examine did present the handled group had a 49% better probability of growing diabetic retinopathy. This doubtlessly blinding harm to the light-sensitive tissue lining the again of the eyes usually accompanies diabetes when blood sugar ranges usually are not underneath management.
“Our study results are the strongest evidence to date that GLP-1 agonist drugs are largely safe and effective tools for addressing type 2 diabetes in kidney transplant recipients,” stated examine lead investigator, transplant surgeon, and weight problems drugs specialist Babak Orandi, MD, Ph.D.
“Our research offers a large amount of real-world clinical data to guide the management of benefits and risks of GLP-1 use in kidney transplant recipients,” stated Orandi, an affiliate professor within the Departments of Surgical procedure and Medication at NYU Grossman Faculty of Medication.
The examine was designed to make clear the worth and security of the medicine. Researchers reviewed the medical data of 18,016 kidney transplant recipients with pretransplant diabetes in america between 2013 and 2020, of whom 1,916 had been prescribed GLP-1s.
“Our findings also show that while the benefits of GLP-1 drugs are significant, their use does come with some added risk of diabetic retinopathy, suggesting that physicians need to carefully monitor the eye health of kidney transplant recipients with diabetes who are started on these drugs,” stated examine senior investigator and epidemiologist Mara McAdams-DeMarco, Ph.D. McAdams-Demarco is an affiliate professor within the Departments of Surgical procedure and Inhabitants Well being at NYU Grossman Faculty of Medication.
Folks with diabetes lose the power to supply or effectively use insulin, the hormone produced by the pancreas and wanted to control the physique’s blood sugar and power ranges.
As a result of diabetic retinopathy, the main reason behind blindness in america, can happen in folks whose blood sugar ranges are corrected too shortly, Orandi says the important thing to managing its threat is to display for diabetic retinopathy, notably in folks with uncontrolled diabetes, and be sure that blood sugar ranges are underneath management previous to taking GLP-1s.
He additionally suggests slowly adjusting GLP-1 doses from small to massive (titrating) in kidney transplant recipients with extreme diabetes or in sufferers with a historical past of eye issues.
Among the many examine’s different findings was that GLP-1 customers had been extra prone to be youthful, feminine, Black, and poor than those that weren’t prescribed the medicines.
For the examine, researchers used information from the U.S. Renal Knowledge System, which integrates information from the Organ Procurement and Transplantation Community that allocates organ transplantation throughout North America, the U.S. Facilities for Medicare and Medicaid Providers, and Medicare claims information, together with data on prescription drug use.
Extra analysis is required, the researchers say, into the organic mechanisms behind GLP-1 agonists and the way they enhance kidney well being posttransplant.
Sort 2 diabetes is among the many main causes of end-stage kidney illness, the first trigger for a quarter-million Individuals now awaiting a kidney transplant.
Extra data:
GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort examine, The Lancet Diabetes & Endocrinology (2025). DOI: 10.1016/S2213-8587(24)00371-1
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Anti-obesity medicine discovered to profit kidney transplant recipients with kind 2 diabetes (2025, March 5)
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