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

 Youngsook Kim  ;  Ji Hye Huh  ;  Minyoung Lee  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Byung-Wan Lee 
 FRONTIERS IN ENDOCRINOLOGY, Vol.13 : 880164, 2022-06 
Journal Title
Issue Date
Blood Glucose / analysis ; Diabetes Mellitus, Type 2* / drug therapy ; Glucagon-Like Peptide-1 Receptor / agonists ; Glucagon-Like Peptides / analogs & derivatives ; Humans ; Immunoglobulin Fc Fragments ; Insulin* ; Recombinant Fusion Proteins ; Retrospective Studies
GLP-1 receptor agonist ; insulin therapy ; switching to GLP-1 receptor agonist ; type 2 diabetes ; type 2 diabetes inadequately controlled with insulin therapy
Aims: Glucagon-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 methods: We 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.

Results: Of 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.

Conclusions: A 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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Young Sook(김영숙)
Lee, Minyoung(이민영) ORCID logo https://orcid.org/0000-0002-9333-7512
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
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