From the Guidelines
Lixisenatide is not contraindicated for patients with retinopathy. Patients with diabetic retinopathy can generally use lixisenatide (brand name Adlyxin), which is a GLP-1 receptor agonist used to treat type 2 diabetes. However, caution is advised as rapid improvement in glucose control with any diabetes medication, including lixisenatide, may temporarily worsen diabetic retinopathy in some patients. This worsening occurs because quick normalization of blood glucose can cause changes in retinal blood flow and temporary progression of retinopathy before eventual improvement.
Key Considerations
- Patients with existing retinopathy should have regular eye examinations when starting lixisenatide or adjusting the dose.
- The standard dosing of lixisenatide begins with 10 mcg once daily for 14 days, then increases to 20 mcg once daily, administered within one hour before the first meal of the day.
- If you have diabetic retinopathy, inform your healthcare provider so they can monitor your eye condition appropriately while you're on this medication.
- According to the most recent guidelines, including those from 1, there is no direct contraindication of lixisenatide in patients with retinopathy, emphasizing the importance of managing glycemic control to reduce the risk or slow the progression of diabetic retinopathy.
Important Recommendations
- Implement strategies to help people with diabetes reach glycemic goals to reduce the risk or slow the progression of diabetic retinopathy.
- Implement strategies to help people with diabetes reach blood pressure and lipid goals to reduce the risk or slow the progression of diabetic retinopathy, as suggested by 1 and other recent studies.
Conclusion Not Applicable
Instead, focusing on the key points and recommendations:
- Regular monitoring and management of diabetic retinopathy are crucial when initiating or adjusting lixisenatide.
- Healthcare providers should be informed about the patient's retinopathy status to ensure appropriate monitoring and care.
- The use of lixisenatide, like other GLP-1 receptor agonists, should be considered as part of a comprehensive diabetes management plan that includes glycemic control, blood pressure management, and lipid control, as highlighted in recent guidelines 1.
From the Research
Lixisenatide and Retinopathy
- The study 2 suggests that lixisenatide has a protective effect on the diabetic retina, due to its neuroprotective, anti-inflammatory, and antioxidative effects on the neurovascular unit.
- However, the study 3 found that GLP-1 receptor agonists, including lixisenatide, were associated with an increased risk of early-stage diabetic retinopathy.
- Another study 4 found that GLP-1 receptor agonists, including lixisenatide, were associated with an elevated risk of rapidly worsening diabetic retinopathy in patients with type 2 diabetes.
- In contrast, the study 5 found no association between GLP-1 receptor agonist exposure, including lixisenatide, and severe diabetic retinopathy.
- The study 6 discusses the potential use of lixisenatide in the treatment of type 2 diabetes, but does not specifically address its effects on retinopathy.
Contraindication for Retinopathy
- Based on the available evidence, it is unclear whether lixisenatide is contraindicated for retinopathy, as the studies have yielded conflicting results.
- Some studies suggest that lixisenatide may have a protective effect on the diabetic retina, while others suggest that it may be associated with an increased risk of diabetic retinopathy.
- Further research is needed to fully understand the effects of lixisenatide on retinopathy and to determine whether it is contraindicated for patients with this condition.