Patients with type 2 diabetes with some kidney failure have few treatment options, and some of those options aren’t ideal.
An international clinical research study involving a UNMC physician/researcher showed an oral drug, semaglutide, was safe and effective in managing patients with type 2 diabetes and kidney disease.
Cyrus Desouza, M.B.B.S., an endocrinologist and professor in the UNMC Department of Internal Medicine’s Division of Diabetes, Endocrinology and Metabolism, was senior author of the study published in the journal Lancet Diabetes Endocrinology.
Dr. Desouza said the drug is the first oral mediation in the GLP-1 agonist drug class to be used to treat type 2 diabetes. The drug is available as an injection, but injections may not be ideal for some patients.
“We feel good about this large study, which answers important questions,” said Dr. Desouza, who also led the clinical research study at UNMC. “This drug will give us another way to lower blood sugars. It can be safely used and is pretty effective in lowering A1C by 1 percent — which is actually very good for kidney failure patients.”
Dr. Desouza and his colleagues found semaglutide appears to provide an important addition to the currently suboptimal treatment options for patients with type 2 diabetes and moderate kidney failure.
In type 2 diabetes patients who have low kidney function, few medications are safe for managing blood sugar. Dr. Desouza said insulin is almost always used, but it can often cause low blood sugars, which is not good for patients. Other drugs usually cannot be used because of the low kidney function, and some are not very effective, he said.
In the randomized, double-blind study, which means neither the researchers nor the study participants knew what drug was being administered, one group received the study drug and the other a placebo for 26 weeks.
The phase III study was conducted at 88 sites in eight countries with 320 patients with moderate chronic kidney disease. Researchers found the once-daily, oral semaglutide was superior to placebo in decreasing blood sugar and bodyweight in patients with type 2 diabetes and moderate renal impairment.
Dr. Desouza said larger studies are needed to better define the place of oral semaglutide.
The study was supported primarily by Novo Nordisk, a pharmaceutical company.
Disclosure of authors/principal investigator interests: Dr. Desouza has received grants, personal fees, and non-financial support from Novo Nordisk, and grants from the National Institutes of Health, REPOWER, Sanofi, and Theracos.