Switching from insulin to dulaglutide therapy in patients with type 2 diabetes: A real‐world data study

Lee, Jiwoo; Kim, Hwi Seung; Jung, Chang Hee; Park, Joong‐Yeol; Lee, Woo Je

doi:10.1002/dmrr.3466

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Second, we found that older age, a higher dose of insulin at the time of switching to dulaglutide, and a low level of postprandial glucose were significant predictive factors for insulin resumption after switching from insulin to weekly dulaglutide. Previous studies have investigated the effectiveness of switching from insulin to dulaglutide in reducing HbA1c levels and body weight in patients with T2D (16). In contrast to our study, the patients used a lower dose of insulin (about 20U/day), and approximately 94% of the enrolled patients used only basal insulin with OHAs.…”

Section: Discussionmentioning

confidence: 77%

Tolerability and Effectiveness of Switching to Dulaglutide in Patients With Type 2 Diabetes Inadequately Controlled With Insulin Therapy

et al. 2022

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AimsGlucagon‐like peptide 1 (GLP-1) receptor agonists have demonstrated strong glycemic control. However, few studies have investigated the effects of switching from insulin to GLP-1 receptor agonists. We aimed to investigate, using real-world data, whether switching to dulaglutide improves glycemic control in patients with type 2 diabetes mellitus (T2D) inadequately controlled with conventional insulin treatment.Materials and methodsWe retrospectively evaluated 138 patients with T2D who were switched from insulin to dulaglutide therapy. We excluded 20 patients who dropped out during the follow-up period. The participants were divided into two groups according to whether they resumed insulin treatment at 6 months after switching to a GLP-1 receptor agonist (group I) or not (group II). A multiple logistic regression analysis was performed to evaluate the parameters associated with the risk of resuming insulin after replacement with dulaglutide.ResultsOf 118 patients initiated on the GLP-1 receptor agonist, 62 (53%) resumed insulin treatment (group I), and 53 (47%) continued with GLP-1 receptor agonists or switched to oral anti-hypoglycemic agents (group II). Older age, a higher insulin dose, and lower postprandial glucose levels while switching to the GLP-1 receptor agonist were associated with failure to switch to the GLP-1 receptor agonist from insulin.ConclusionsA considerable proportion of patients with T2D inadequately controlled with insulin treatment successfully switched to the GLP-1 receptor agonist. Younger age, a lower dose of insulin, and a higher baseline postprandial glucose level may be significant predictors of successful switching from insulin to GLP-1 receptor agonist therapy.

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Section: Discussionmentioning

confidence: 77%

Tolerability and Effectiveness of Switching to Dulaglutide in Patients With Type 2 Diabetes Inadequately Controlled With Insulin Therapy

et al. 2022

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“…People with T2D who do not achieve recommended glycemic targets may eventually require treatment intensification with insulin or a glucagon-like peptide-1 receptor agonist (GLP-1 RA), such as dulaglutide, or the gastric inhibitory peptide (GIP) and GLP-1 dual receptor agonist, tirzepatide [ 11 ]. Choice of glucose-lowering agents in T2D should be guided by clinical considerations (e.g., presence or high risk of cardiovascular disease, heart failure, chronic kidney disease, and hypoglycemia), side effect profiles of medications, contraindications, and individual preferences [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Glycemic and Cost Outcomes among Hispanic/Latino People with Type 2 Diabetes in the USA Initiating Dulaglutide versus Basal Insulin: a Real-World Study

Hoog,

Maldonado,

Wangia-Dixon

et al. 2024

Diabetes Ther

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Introduction Optimal glycemic management after diabetes onset remains a challenge in Hispanic/Latino adults with type 2 diabetes (T2D), often resulting in poor health outcomes and higher rates of diabetes-related complications. The aim of this study was to examine and compare demographic and clinical characteristics, glycemic outcomes, health care resource utilization (HCRU), and costs among injection-naïve Hispanic/Latino adults with T2D initiating dulaglutide or basal insulin. Methods This retrospective, observational study used administrative claims data from the Optum Research Database. Hispanic/Latino adults with T2D were assigned to dulaglutide or basal insulin cohorts on the basis of pharmacy claims and were propensity-score matched on demographic and baseline characteristics. Measures of glycemic management included 12 month follow-up glycated hemoglobin (HbA1c) and change in HbA1c from baseline. Follow-up all-cause and diabetes-related HCRU and costs, including costs per 1% change in HbA1c, were compared between cohorts. Results The final propensity-score matched sample included 2872 patients: 1436 patients in each cohort. Mean (SD) reduction in HbA1c from baseline to 12 month follow-up was greater in the dulaglutide cohort compared with the basal insulin cohort [−1.40% (1.88) versus −0.92% (2.07); p < 0.001]. The dulaglutide cohort had significantly lower proportions of patients with ≥ 1 all-cause and diabetes-related outpatient visits, emergency room visits, and inpatient stays compared with the basal insulin cohort ( p < 0.05). The dulaglutide cohort had significantly lower all-cause total costs per 1% HbA1c reduction than the basal insulin cohort ($13,768 versus $19,128; p < 0.001). Diabetes-related costs per 1% reduction were numerically lower for the dulaglutide cohort, but the difference was not statistically significant ($9737 versus $11,403; p = 0.081). Conclusions Dulaglutide demonstrated better glycemic outcomes and lower all-cause costs per 1% HbA1c reduction among Hispanic/Latino adults compared with those initiating basal insulin. Our real-world findings in the Hispanic/Latino population were consistent with results obtained from the overall population and confirm the glycemic benefits of dulaglutide observed in clinical settings. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-024-01542-5.

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The new dual gastric inhibitory peptide/glucagon‐like peptide 1 agonist tirzepatide in type 2 diabetes: Is the future bright?

Papachristou

Popovic

Παπάνας

2021

Diabetes Metabolism Res

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Tirzepatide is a dual gastric inhibitory peptide/glucagon‐like peptide 1 (GIP/GLP‐1) receptor agonist formulated as a synthetic linear peptide, based on the native GIP sequence. It has a prolonged half‐life of 5 days, which enables once‐weekly dosing. Studies have hitherto demonstrated its superiority in achieving optimal glycaemic control and body weight management, as compared with various agents used in the treatment of type 2 diabetes mellitus (T2DM), including GLP‐1 receptor agonists. Thus, it is expected to enrich our therapeutic armamentarium in T2DM. However, further experience, notably longer follow‐up data and information on cardiovascular effects, is still needed.

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Switching from insulin to dulaglutide therapy in patients with type 2 diabetes: A real‐world data study

Cited by 3 publications

References 27 publications

Tolerability and Effectiveness of Switching to Dulaglutide in Patients With Type 2 Diabetes Inadequately Controlled With Insulin Therapy

Tolerability and Effectiveness of Switching to Dulaglutide in Patients With Type 2 Diabetes Inadequately Controlled With Insulin Therapy

Glycemic and Cost Outcomes among Hispanic/Latino People with Type 2 Diabetes in the USA Initiating Dulaglutide versus Basal Insulin: a Real-World Study

The new dual gastric inhibitory peptide/glucagon‐like peptide 1 agonist tirzepatide in type 2 diabetes: Is the future bright?

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