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Effect of dulaglutide and long-acting insulin combination therapy in patients with type 2 diabetes: a retrospective observational study

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Abstract

Objective

The study aimed to evaluate the long-term effects of combination therapy comprising dulaglutide and long-acting insulin, on glycemic control in patients with type 2 diabetes.

Methods

This retrospective observational study included 20 patients with type 2 diabetes who underwent blood glucose management with intensive insulin therapy for a limited period. All patients were switched from intensive insulin therapy to combination therapy comprising dulaglutide and long-acting insulin. Hemoglobin A1c was evaluated before and 4, 12, and 24 weeks after starting combination therapy. Continuous glucose monitoring was conducted before and 1 and 24 weeks after starting combination therapy.

Results

Hemoglobin A1c levels were significantly reduced after 4, 12, and 24 weeks of combination therapy (− 2.2% ± 0.4%, P < 0.0001; − 3.7% ± 0.8%, P = 0.0003; and − 3.6% ± 0.8%, P = 0.0005, respectively). Glycemic variability (% coefficient of variation) was significantly decreased after 1 and 24 weeks of combination therapy (− 5.7% ± 2.1%, P = 0.011; and − 8.7% ± 2.4%, P = 0.003, respectively) and the percentage of readings and time > 250 mg/dL at 24 weeks was significantly improved (− 2.2% ± 0.8%, P = 0.019).

Conclusion

Combination therapy with dulaglutide and long-acting insulin resulted in better blood glucose control than intensive insulin therapy, which persisted for 24 weeks. Combination therapy also reduced blood glucose fluctuations and the number of self-injections needed.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Chigasaki Municipal Hospital, Chigasaki, 253-0042, Japan

    Kohei Ito, Shinobu Satoh, Haruka Tamura & Masanori Hasebe

  2. Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama, Japan

    Yoshinobu Kondo

  3. Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Yasuo Terauchi

Authors
  1. Kohei Ito
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  2. Shinobu Satoh
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  3. Yoshinobu Kondo
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  4. Haruka Tamura
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  6. Yasuo Terauchi
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Contributions

KI contributed to conception, design, data collection, analysis, interpretation writing the first draft, and editing. YK contributed to methodology, MH, HT, and SS contributed to the conception, data collection, and interpretation. YT contributed to supervision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shinobu Satoh.

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Conflict of interest

Yasuo Terauchi has received honoraria from MSD, Ono Pharmaceutical Co. Ltd., Boehringer Ingelheim, Takeda, Mitsubishi Tanabe Pharma, Daiichi Sankyo, Sanwa Kagaku Kenkyusho, Novo Nordisk A/S, Eli Lilly, Sanofi, Sumitomo Dainippon Pharma, Shionogi, Bayer Yakuhin, Astellas Pharma, and AstraZeneca and subsidies or donations from MSD, Ono Pharmaceutical Co. Ltd., Boehringer Ingelheim, Novartis, Takeda, Daiichi Sankyo, Sanwa Kagaku Kenkyusho, Novo Nordisk A/S, Eli Lilly, Sanofi, and Sumitomo Dainippon Pharma. Shinobu Satoh has received honoraria from Novo Nordisk Pharma Ltd. and Eli Lilly. Kondo Yoshinobu has received honoraria from Novo Nordisk Pharma Ltd. Kohei Ito, Haruka Tamura, and Masanori Hasebe declare that they have no conflict of interest.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions.

Informed consent

An alternative of informed consent was obtained from all patients for being included in the study.

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Ito, K., Satoh, S., Kondo, Y. et al. Effect of dulaglutide and long-acting insulin combination therapy in patients with type 2 diabetes: a retrospective observational study. Diabetol Int 14, 51–57 (2023). https://doi.org/10.1007/s13340-022-00592-z

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