Once Weekly GLP-1 in Persons With Spinal Cord Injury
Status:
Not yet recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Chronic spinal cord injury (SCI) results in adverse soft tissue body composition changes and
an extremely sedentary lifestyle. These abrupt changes often lead to a high prevalence of
cardiometabolic diseases, such as impaired glucose tolerance/diabetes mellitus and
dyslipidemia, conditions which predispose those with SCI to an increased risk for
cardiovascular disease compared to the general population. Due to paralysis and wheel chair
dependence, maintaining an adequate level of physical activity to counteract these
deleterious metabolic changes presents a unique obstacle because conventional first line
interventions are lifestyle modifications (e.g., diet and exercise), which may be difficult
to achieve. Recently, a new medication has been approved by the Food and Drug Administration
to improve glycemic control in individuals with diabetes mellitus, and it has also been
investigated as an off-label treatment to induce weight loss. Glucagon-like peptide-1 (GLP-1)
agonists are a class of drugs designed to mimic the endogenous incretin hormones released
from the gut in a glucose dependent manner following a meal. The mechanisms of action for
this drug class of medications include stimulation of glucose-dependent insulin secretion,
inhibiting glucagon release, slowed gastric emptying, and reduction of postprandial glucose
excursions following food intake. In addition to improved glycemic control, this class of
medications also shows promise for its non-glycemic action of facilitating weight loss. The
method of delivery of the GLP-1's is by self-administered injections once daily or once
weekly, depending on the severity of the clinical case and therapeutic targets for a specific
patient.