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

2020 ◽  
Vol 16 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Aneesh Ghosh ◽  
Rakhee Nair

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.

2015 ◽  
Vol 6 (6) ◽  
pp. 16-19 ◽  
Author(s):  
Devendra Pratap Singh Rajput ◽  
Javed Yusuf Shah ◽  
Priti Singh ◽  
Shyransh Jain

Back ground: In type 2 diabetes mellitus lipid abnormalities are almost the rule. Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal, cerebrovascular and cardiovascular disease cause the most morbidity and mortality in this group of patients.Aims and Objectives: This study is aimed at understanding the pattern of dyslipidemia among type 2 diabetic patients. Materials and Methods: During two month study period, total 100 patients with diabetes mellitus were evaluated for dyslipidemia. Plasma glucose was estimated by GOD –POD method and Lipid profile by photometry method. Lipid profile was evaluated by investigating the subjects for total cholesterol, serum triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein. In statistical analysis data were analyzed by using various statistical methods like percentage, proportions and tables by using epi info software.Results: Out of 100 patients 72(72%) were males and 28(28%) were females. The mean  fasting blood sugar of total patients with type 2 diabetes mellitus was 158.35mg/dl. in male diabetics, fasting blood sugar level with diabetes mellitus was 157.56mg/dl and in female diabetics it was 159.14mg/dl. The pattern of dyslipidemia in our study showed significantly higher levels of serum cholesterol, serum triglyceride, LDL-C in both male and female diabetics and lower levels of HDL-C in female diabetics. There was no significant difference in lipid profile pattern in male and female diabetic patients except lower levels of HDL-C in female diabetic patients. Conclusion: This study showed that dyslipidemia is highly prevalent among type 2 diabetic patients. DOI: http://dx.doi.org/10.3126/ajms.v6i6.12452Asian Journal of Medical Sciences Vol.6(6) 2015 16-19                                     


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xue Cao ◽  
Zhe Tang ◽  
Jie Zhang ◽  
Haibin Li ◽  
Manjot Singh ◽  
...  

Abstract Background Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration. Methods In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables. Results Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62–1.55), 0.48 (95% CI: 0.27–0.85) and 0.44 (95% CI: 0.25–0.80) for individuals with HDL-C levels within the 1.15–1.39, 1.40–1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes). Conclusions Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese.


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