Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients

Abstract

Introduction: Preclinical research suggests a role of Glucagon Like Peptide-1 Receptors (GLP-1R) on the regulation of human bronchial tone. We investigated the effect of GLP-1R agonists on lung function of Type 2 Diabetes Mellitus (T2DM) population without co-existing chronic obstructive respiratory disorders. Methods: This was a prospective cohort study that examined change in lung function measurements over two years of T2DM patients (n = 32) treated with metformin monotherapy (control cohort), metformin plus GLP-1R agonists (GLP-1R agonists cohort), or metformin plus insulin (insulin cohort). Results: After 24 months of treatment, the forced expiratory volume in 1 s (FEV 1 ) significantly (p < 0.05) increased from baseline in the GLP-1R agonists cohort (218 ml [95%CI 88-246]), but not in the control and insulin cohorts (94 ml [95%CI -28 -216] and 26 ml [95%CI -174 -226], respectively; p > 0.05 vs. baseline). The average increase in FEV 1 in the GLP-1R agonists cohort was significantly greater than that in the control and insulin cohorts (delta: 110 ml [95%CI 18-202] and 177 ml [95%CI 85-270], respectively, p < 0.05). The forced vital capacity (FVC) also increased significantly more in the GLP-1R agonists cohort than in the control and insulin cohorts (overall delta FVC: 183 ml [95%CI 72-295], p < 0.05). The maximal expiratory flow at 50-75% significantly (p < 0.05) improved from baseline in the GLP-1R agonists cohort, but not in the control and insulin cohorts (p > 0.05). Conclusion:Our preliminary results suggest a potential new therapeutic perspective to treat airway disorders with GLP-1R agonists.

Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression

“…[35] Animal studies in mice with experimental lung injury also showed that GLP-1RA reduce mucus secretion, and preserve lung function. [38][39][40][41][42] In addition, Rogliani et al [43] reported that GLP-1RAs improves forced expiratory volume in 1 s -FEV1, forced vital capacity -FVC, and maximal expiratory flow at 75% and 50% -MEF75 and MEF50 in diabetes mellitus patients, regardless on their blood glucose levels.…”

SGLT‐2 inhibitors and the risk of hospitalization for community‐acquired pneumonia: A population‐based cohort study

“…30 The observed null association for HCAP when SGLT2 inhibitors were compared with GLP-1 RA adds some support of this hypothesis. Indeed, several studies have reported protective associations between the use of GLP-1 RA and respiratory function [31][32][33] and risk of infections. 34 Second, it is also possible that the observed protective association is the result of an increased risk of pneumonia with DPP-4i.…”

Use of GLP1RAs and occurrence of respiratory disorders: A meta‐analysis of large randomized trials of GLP1RAs

“…Although better glucose control from GLP1RAs may lead to low incidence of pneumonia in T2D that cannot completely explain the benefits from GLP1RAs on all the nine kinds of respiratory conditions assessed in the study. In contrast, some possible mechanisms for the benefits from GLP1RAs on relevant respiratory diseases are revealed by several small sample human studies 12,13 and animal studies 14,15 in which GLP1RAs were observed to benefit for COPD, 12,13 airway hyperresponsiveness, 14 and acute lung injury 15 via immunomodulating and antiinflammatory effects.…”