Dulaglutide and Glomerular Hyperfiltration, Proteinuria, and Albuminuria in Youth With Type 2 Diabetes: Post Hoc Analysis of the AWARD-PEDS Study

Diabetes Care. 2024 Sep 1;47(9):1617-1621. doi: 10.2337/dc24-0322.

Abstract

Objective: To examine changes in glomerular hyperfiltration and other measures of kidney function in youth with type 2 diabetes treated with dulaglutide or placebo.

Research design and methods: Post hoc analysis was performed on kidney laboratory data from 154 youths (age 10-18 years) with type 2 diabetes enrolled in a completed placebo-controlled glycemic control trial of dulaglutide.

Results: Mean estimated glomerular filtration rate (eGFR) decreased from baseline to 26 weeks in participants treated with dulaglutide versus placebo (-5.8 vs. -0.1 mL/min/1.73 m2; P = 0.016). Decreases in eGFR were observed primarily in participants with baseline glomerular hyperfiltration. At 26 weeks, the prevalence of both glomerular hyperfiltration and proteinuria increased with placebo but decreased with dulaglutide (P = 0.014 and 0.004 vs. placebo, respectively).

Conclusions: Dulaglutide was associated with attenuated glomerular hyperfiltration and proteinuria in youth with type 2 diabetes. The impact of these changes on the risk of diabetic kidney disease is unclear.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Albuminuria* / physiopathology
  • Child
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / physiopathology
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / physiopathology
  • Female
  • Glomerular Filtration Rate*
  • Glucagon-Like Peptides* / analogs & derivatives
  • Glucagon-Like Peptides* / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Immunoglobulin Fc Fragments* / therapeutic use
  • Male
  • Proteinuria* / physiopathology
  • Recombinant Fusion Proteins* / therapeutic use

Substances

  • dulaglutide
  • Recombinant Fusion Proteins
  • Glucagon-Like Peptides
  • Immunoglobulin Fc Fragments
  • Hypoglycemic Agents

Grants and funding