Favorable Effect on Blood Volume Control in Hemodialysis Patients with Type 2 Diabetes after Switching from Insulin Therapy to Liraglutide, a Human Glucagon-like Peptide-1 Analog--Results from a Pilot Study in Japan-.

Objective: Hemodialysis patients are advised to limit the intake of foods in order to control volume status and body weight (BW). We report the clinical course of five Japanese hemodialysis patients with type 2 diabetes mellitus (T2DM) who were switched from insulin to liraglutide, and the efficacy of the treatment, especially in terms of changes in interdialysis weight gain (IDWG).

Methods: This retrospective pilot study included 5 Japanese hemodialysis patients with T2DM. Insulin and other oral hypoglycemic agents, if any, were discontinued before switching to liraglutide. The initial dose of liraglutide was set at 0.3 mg/day for more than 1 week, increased to 0.6 mg/day for more than 1 week and then, to 0.9 mg/day if needed.

Results: At baseline, the mean body mass index (BMI) was 23.2 ± 1.2 kg/m and mean IDWG was 2.0 ± 0.4 kg. The required dose of liraglutide ranged from 0.3 to 0.9 mg/day. At the end of 3-month treatment, liraglutide reduced HbA1c level, BMI, and IDWG. A significant decrease in cardiothoracic ratio was confirmed on chest radiography.

Conclusion: Switching from insulin to liraglutide seems effective in hemodialysis patients with T2DM, especially in those with difficult blood fluid volume control associated with failure of dietary restriction.