# The Impact of Glucagon-like Peptide-1 Receptor Agonists on Cardiovascular–Kidney–Metabolic Health in Romanian Patients with Type 2 Diabetes: A Retrospective Study

## TL;DR

This study shows that GLP-1 receptor agonists improve heart, kidney, and metabolic health in Romanian patients with type 2 diabetes over a year.

## Contribution

The study provides real-world evidence of GLP-1 RA benefits in a Romanian T2D population over 12 months.

## Key findings

- 59.3% of patients achieved over 5% weight loss after 12 months of GLP-1 RA treatment.
- GLP-1 RA treatment improved HbA1c, lipid profile, blood pressure, and slowed kidney function decline.
- Significant improvements in metabolic markers occurred within the first 6 months of treatment.

## Abstract

Background/objectives: Chronic degenerative complications of diabetes, such as atherosclerotic cardiovascular disease and chronic kidney disease, contribute to an increased morbimortality in patients with type 2 diabetes (T2D), and thus, a multifactorial approach becomes essential. Among the classes of antihyperglycemic agents with beneficial pleiotropic cardiorenal effects, the glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven to reduce the risk of major adverse cardiovascular (CV) and renal events. This study aims to assess the impact of treatment with GLP-1 RA on CV risk factors, insulin sensitivity, and renal function in Romanian patients with T2D. Methods: In an observational retrospective study, 150 patients with T2D were evaluated at the start of therapy with a GLP-1 RA and then after 6 and 12 months. Results: After 12 months of treatment, 59.3% of patients succeeded in achieving weight loss of over 5% of their initial weight, and 24.7% of patients achieved weight loss of over 10% of their initial weight, with the most significant decrease being measured in the first 6 months. HbA1c has shown a similar profile, with a significant reduction in the first 6 months of treatment, continued at a slower rate in the following 6 months. Additionally, the lipid profile, blood pressure values, and uric acid values, alongside the triglyceride/high-density lipoprotein cholesterol (TG/HDLc) ratio and the triglyceride–glucose (TyG) index have improved in these T2D patients treated with GLP-1 RA, while their eGFR decrease was slower than the one expected for similar populations without such a pharmacologic agent in their regimen. Conclusions: Treatment with GLP-1 RA in patients with T2D is associated with an improved cardiovascular–kidney–metabolic risk profile, ameliorated glycemic control, reduced weight, lower insulin resistance, and slower kidney disease progression.