Once Weekly GLP-1 in Persons With Spinal Cord Injury

1. Male or female, age 18 to 69;

2. Chronic (e.g., duration of injury greater than 3 years) stable SCI (regardless of level of neurological injury);

3. ASIA A-D (non-ambulatory defined as not able to weight bear for more than 20% of the day);

4. Obese Percent Body Fat defined as > 25% for men and > 35% for women (as determined by screening DXA scan);

5. Insulin Resistant as determined at screening: (FPI, ≥15 µU/ml); -OR-

6. Pre-diabetic, as determined by any one of the following:

1. HbA1C ≥ 5.7% and < 6.4%; or

2. Impaired glucose tolerance by FSG ≥100 mg/dl and < 125 mg/dl and/or the 2 hour serum glucose concentration (after an OGTT) ≥ 140 mg/dl and < 200 mg/dl

1. Personal history of or family history of medullary thyroid carcinoma;

2. History of multiple endocrine neoplasia syndrome type 2;

3. History of pancreatitis;

4. Existing diagnosis of diabetes mellitus, or the results from screening OGTT that identify diabetes mellitus (previously undiagnosed); laboratory thresholds for exclusion will be as follows: HbA1C ≥6.5%, fasting plasma glucose >126 mg/dl, or 2 hour value >200 mg/dl;

5. Receiving treatment for impaired glucose metabolism (i.e., insulin, secretagogues, or other agents to modify peripheral insulin sensitivity or serum glucose concentration);

6. Reduced kidney function (by glomerular filtration rate (GFR <60 ml/min) or liver function tests (any single LFT ≥ 2.5 times above the upper limit of normal) as determined by test results at screening and any time point of the study;

7. Elevated calcitonin level (as determined at screening to rule out thyroid cancer);

8. Pregnancy or women who may become pregnant during the course of the study, or those who are nursing;

9. Medically unstable;

10. Acute illness or infection;

11. Diminished mental capacity; and

12. Inability or unwillingness of subject to provide informed consent.