Two classes of newer medications for glycemic control in type 2 diabetes differed in hyperkalemia risk and discontinuation of renin-angiotensin system inhibitors, a large cohort study found.
In patients with type 2 diabetes , the use of glucagon-like peptide 1 receptor agonists is associated with lower rates of hyperkalemia and sustained use of guideline-recommended renin-angiotensin system inhibitors compared with the use of dipeptidyl peptidase-4 inhibitors .
The study included 33,280 patients with T2D who were new users of any GLP-1 RA or DPP-4i between 2008 and 2021. In a secondary analysis, the persistence to RASi therapy was evaluated in a subgroup of 21,751 patients with T2D who were using RASis at the time of initiating GLP-1 RA or DPP-4i.Stopping or switching treatments was common. During a median follow-up of 3.9 months, 752 patients experienced at least one hyperkalemia event, with incidence rates of 21.0 per 1000 person-years for GLP-1 RA initiators and 39.0 for DPP-4i initiators.
RASi discontinuation rates were lower in patients who initiated GLP-1 RAs, with an incidence rate of 146.2 per 1000 person-years compared with 170.2 for DPP-4i users .
Diabetes Mellitus Type Ii Type 2 Diabetes Type 2 DM T2DM T2D Hyperkalemia Hyperkalaemia Renin-Angiotensin System Renin-Angiotensin-Aldosterone System Ras - Renin-Angiotensin System Raas - Renin-Angiotensin-Aldosterone System Clinical Guidelines Guidelines Heart Receptors Hypertension Renal Disease Kidney Disease Kidney Disorder Renal Disorder Nephropathy
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