Improved Clinical Outcomes with Dulaglutide as Add-on Medication to Oral Antidiabetic Drugs with or Without Insulin in Overweight Indian Patients with Type 2 Diabetes Mellitus: Retrospective Study in a Real-World Setting

Abstract

Aim: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated several extra-pancreatic benefits in addition to glycemic control. This study retrospectively evaluates the realworld clinical effectiveness of dulaglutide as add-on therapy in overweight patients with inadequately controlled type 2 diabetes mellitus (T2DM). Materials and Methods: This single-center study included overweight adult patients (N, 85; women, 45) with inadequately controlled T2DM (mean glycated hemoglobin [HbA1c] (standard deviation [SD]), 7.55 [0.43] %; and body mass index [BMI] [SD], 29.01 [2.30] kg/m2) treated with dulaglutide (1.5 mg) once weekly as an add-on therapy. Follow-up improvements in outcomes were analyzed using the paired t-test. Subgroup analysis was performed for selected outcomes. Safety parameters were also evaluated. Results: At the 20-week follow-up, dulaglutide based therapy demonstrated a significant reduction (P<.001) in HbA1c, body weight and BMI, with a mean reduction (MR [SD]) of 0.45 [0.38] %, 5.06 [2.33] kg, and 1.82 [0.81] kg/m2, respectively, in the overall population. Similarly, reduction in urine albumin/creatinine ratio [U-ACR] (6.04 [15.53] mg/g), cholesterol (3.24 [4.14] mg/dL), triglycerides (16.60 [12.39] mg/dL), very-low-density lipoprotein [VLDL] (3.31 [2.48] mg/dL), serum glutamicoxaloacetic transaminase (1.80 [2.92] U/L) and glutamic-pyruvic transaminase (8.00 [5.64] U/L) was also significant (P<.05). Target HbA1c of <7% was achieved in 40% of patients. Reduction in HbA1c and body weight was significant across all subgroups analyzed. Predominantly, gastrointestinal adverse events were reported. Conclusion: Dulaglutide as an add-on therapy was well tolerated with significant improvement in HbA1c, body weight, BMI, U-ACR, lipid fractions and serum transaminases in overweight Indian patients with T2DM.

Real-World Efficacy and Safety of Dulaglutide in Korean Patients with Type 2 Diabetes Mellitus: A Retrospective Study in a Tertiary Referral Center

“…Several recent real-world studies have shown consistent glucose-lowering efficacy with body weight reduction in patients with T2DM treated with dulaglutide when compared with the results from previous RCTs. 9 10 Similar findings from Korean patients with T2DM were reported in two studies that evaluated the glycemic efficacy of dulaglutide for 6 months. 11 12 However, little is known about the differences in glucoselowering efficacy of dulaglutide according to the background glucose-lowering regimen.…”

Real-world Efficacy and Safety of Dulaglutide in Korean Patients with Type 2 Diabetes Mellitus: A Retrospective Study in a Tertiary Referral Center

“…The initiation of dulaglutide therapy can be considered in various clinical settings; however, given the concerns associated with insurance coverage, dulaglutide is generally used in combination therapy with OAD or basal insulin. Several recent real-world studies have shown consistent glucose-lowering e cacy with body weight reduction in patients with T2DM treated with dulaglutide when compared with the results from previous RCTs [9,10]. Similar ndings from Korean patients with T2DM were reported in two studies that evaluated the glycemic e cacy of dulaglutide for 6 months [11,12].…”

Glucagon-like peptide-1 receptor agonists in non-alcoholic fatty liver disease: An update

“…On the other hand, the administration of dulaglutide for 12 wk at a dose of 0.75 mg once weekly in patients with NAFLD reduced HbA 1c levels, body weight, transaminases and liver stiffness[ 42 ]. In another study in 85 overweight patients with inadequately controlled T2DM conducted in India, treatment with dulaglutide 1.5 mg once weekly for 20 wk resulted in significant reductions in HbA 1c , body weight, ALT and AST levels[ 43 ]. Also, in a post hoc analysis of four randomized, placebo-controlled trials in patients with T2DM ( n = 1499), dulaglutide decreased transaminase and γGT levels compared with placebo, particularly in patients with elevated transaminase levels at baseline[ 44 ].…”