AUTHOR=Otsuka Emiko , Kitamura Mineaki , Funakoshi Satoshi , Mukae Hiroshi , Nishino Tomoya 

TITLE=Improving glycemic control: transitioning from dulaglutide to tirzepatide in patients with type 2 diabetes undergoing hemodialysis

JOURNAL=Frontiers in Pharmacology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1362242

DOI=10.3389/fphar.2024.1362242

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Tirzepatide—a dual glucose-dependent insulinotropic peptide and glucagon-like peptide-1 receptor agonist—is used to treat type 2 diabetes. However, the efficacy and safety of tirzepatide in patients undergoing hemodialysis remain unclear.</p><p><bold>Methods:</bold> We conducted a single-center retrospective study of patients with type 2 diabetes undergoing hemodialysis who were transitioned from dulaglutide to tirzepatide. We continuously monitored glucose levels in patients undergoing hemodialysis before and after switching from dulaglutide to tirzepatide.</p><p><bold>Results:</bold> Fourteen patients (mean age: 61.9 ± 9.9 years, male: female = 11:3) were included in this study. After switching to tirzepatide, time in range increased to 50.8% from 42.7% (<italic>p</italic> = 0.02), time above range decreased to 37.8% from 48.4% (<italic>p</italic> = 0.02), and mean glucose levels decreased to 137.4 mg/dL from 156.6 mg/dL (<italic>p</italic> = 0.006). In contrast, there was no significant difference in time below range before and after tirzepatide administration (11.3% and 8.9%) (<italic>p</italic> = 0.75). Three patients experienced dyspepsia (21.4%), and one patient experienced nausea (7.1%); however, no critical adverse events were reported.</p><p><bold>Conclusion:</bold> Transitioning from dulaglutide to tirzepatide improved glycemic control without increasing hypoglycemia in patients undergoing hemodialysis for type 2 diabetes.</p>