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.
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