Exploring a Suitable Marker of Glycemic Response to Dulaglutide in Patients with Type 2 Diabetes: A Retrospective Study

Yoshiji, Satoshi; Hasebe, Masashi; Iwasaki, Yorihiro; Shibue, Kazuhisa; Keidai, Yamato; Seno, Yohei; Iwasaki, Kanako; Honjo, Sachiko; Fujikawa, Jun; Hamasaki, Akihiro

doi:10.1007/s13300-022-01231-1

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Some natural compounds may be beneficial to glucose fluctuations, and active ingredients previously found in Chinese herbal medicines can significantly reduce glucose and urinary protein levels in patients and animal models ( 27 , 28 ), such as, a coumarin from hydrangea paniculata, slows down the progression of urinary protein exudation by anti-inflammatory effects and inhibiting immune complex deposition. Our study also found that urinary protein excretion rate in the experimental group was significantly reduced compared with the control group, suggesting that dulaglutide is beneficial to improve renal urinary protein exudation in diabetic patients, which was consistent with previous studies ( 29 , von 30 ). In addition, we also found that the FC-P and 2hC-P levels of the patients in the experimental group were significantly higher than those in the control group after 3 and 6 months of treatment.…”

Section: Discussionsupporting

confidence: 92%

Effects of dulaglutide combined with insulin degludec on glucose fluctuations and appetite in type 2 diabetes

et al. 2023

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IntroductionThe aim of this study was to describe appetite and glucose fluctuation in type 2 diabetes mellitus patients initiating treatment with dulaglutide combined with insulin degludec.MethodsThis retrospective study of patients identified adults starting treatment with once-weekly (QW) dulaglutide combined with insulin degludec (experimental group) or insulin degludec alone (control group). Patients were followed for up to 6 months from treatment initiation. The clinical characteristics of patients, treatment patterns, CGM data, and appetite scores were obtained for the two groups.ResultsA total of 236 patients were included in this study. SDBG, MAGE, LAGE, and PPGE of the experimental group were lower than the control group’s (P < 0.05). The proportions of patients achieving a time in range (TIR) of ≥70% in the experimental group were higher than in the control group, with 43% and 10% on the second day, 88% and 47% on the fourth day, 95% and 47% on the seventh day, and 100% and 67% on the tenth day, respectively. Significant associations existed between TIR and the prevalence of islet function. At six months, 89.2% of patients in the experimental group were still using dulaglutide. Appetite decreased significantly at 1 week and increased at 3 months after treatment with dulaglutide.ConclusionDulaglutide combined with insulin degludec significantly reduces glucose fluctuations in patients with type 2 diabetes mellitus and improves the TIR rate. However, the treatment on appetite could decrease in the first three months.

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Section: Discussionsupporting

confidence: 92%

Effects of dulaglutide combined with insulin degludec on glucose fluctuations and appetite in type 2 diabetes

et al. 2023

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“…Although, it is worthy to note that subjects suffering severe cognitive impairment were not involved in this study. Instead, the improvement in HbA1c correlated with CPR and CPI, suggesting that the level of residual beta-cell function is associated with the e cacy of oral semaglutide treatment, which has been shown for other GLP-1RAs (Supplementary table 4) (30) (31) (32).…”

Section: Discussionmentioning

confidence: 83%

Efficacy and safety of oral semaglutide in older patients with type 2 diabetes: a retrospective observational study (the OTARU-SEMA study)

Oe,

Nomoto,

Cho

et al. 2024

Preprint

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Background: Oral semaglutide in older subjects with type 2 diabetes was as effective as in younger subjects, according to phase 3 clinical trials. However, its efficacy can be limited in very aged population, due to the presence of impaired cognitive function and the complex instructions for its use. Here, we investigated its efficacy and safety by further age bracket in older subjects in real-world. Methods: We retrospectively studied subjects >65 years of age with type 2 diabetes who started oral semaglutide treatment. The primary outcome was the change in glycosylated hemoglobin (HbA1c) over 6 months. Adverse events and cognitive function were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) and the Hasegawa Dementia Rating Scale-revised (HDS-R). The achievement rate of glycemic targets was evaluated based on the age, health status of subjects and their use of anti-diabetic agents which can cause hypoglycemia, with additional analysis between two subgroups; early (65-74) versus late (≥ 75) older. Furthermore, we evaluated the relationships between their improvements in HbA1c and the baseline characteristics of the subjects, including their cognitive function and insulin secretory capacity. Results: We studied the efficacy of the drug in 24 subjects. Their HbA1c and body weight significantly decreased (−13.1 ± 7.5 mmol/mol and −3.0±2.4 kg, respectively; P<0.01). Although cognitive function was lower in the late older group (r=−0.57, P<0.01), changes in HbA1c showed no difference between the two subgroups (P=0.66) and it correlated with the insulin secretory capacity rather than cognitive function (r=−0.49, P<0.05). Glycemic targets were more likely to be achieved (P<0.01), but HbA1c excessively decreased in late older subjects who were also using insulin or an insulin secretagogue. The frequency of adverse events was similar to that in the clinical trial, whereas discontinuation of medication were more frequent among the late older subjects (Early; n=2, Late; n=4). Conclusions: Oral semaglutide improves the glycemic control of older subjects, but it might be a risk for potential hypoglycemia and discontinuation in subjects of ≥75 years. Attention should be paid to insulin secretory capacity and concomitant medications rather than concern about adherence.

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Effects of dapagliflozin combined with short-term intensive insulin therapy on β-cell function in patients with newly diagnosed type 2 diabetes mellitus—a randomized controlled study

Lin¹,

Wang²,

Qian³

2022

Int J Diabetes Dev Ctries

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Exploring a Suitable Marker of Glycemic Response to Dulaglutide in Patients with Type 2 Diabetes: A Retrospective Study

Cited by 5 publications

References 30 publications

Effects of dulaglutide combined with insulin degludec on glucose fluctuations and appetite in type 2 diabetes

Effects of dulaglutide combined with insulin degludec on glucose fluctuations and appetite in type 2 diabetes

Efficacy and safety of oral semaglutide in older patients with type 2 diabetes: a retrospective observational study (the OTARU-SEMA study)

Effects of dapagliflozin combined with short-term intensive insulin therapy on β-cell function in patients with newly diagnosed type 2 diabetes mellitus—a randomized controlled study

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