Objective: Dulaglutide (Dula) is a novel, long-acting glucagon-like peptide receptor antagonist (GLP-1RA) used in the treatment of T2D patients with or without renal impairment. In this study we compared by using CGM once-daily Lira and once-weekly Dula, each combined with various doses of insulin degludec (IDeg).

Methods: Eighteen adult HD patients with T2D (men/women, 11/7) who had been treated with once-daily Lira (0.6-0.9 mg) combined with daily IDeg (5-26 units) (Lira + IDeg) were switched to once-weekly Dula 0.75 mg combined with daily IDeg (Dula + IDeg). The dose of IDeg stayed the same in each patoent, and all patients were monitored for PG control by CGM, and the mean amplitude of glycaemic excursions (MAGE) was calculated before and after switching.

Results: A significant reduction was observed in MAGE with Dula + IDeg 4 weeks after switching to Lira + IDeg both in on-HD days (122.3±38.3 mg/dL vs. 66.7±22.1 mg/dL, p<0.001) and off-HD days (88.8±24.1 mg/dL vs. 42.6±20.3 mg/dL, p<0.001). No episode of hypoglycemia, and 4 out of 18 patients reported mild gastrointestinal adverse events with Dula treatment, but were thought to be transient.

Conclusions: Thus, Dula appears to be potentially superior to Lira in reducing PG fluctuations in HD patients with T2D receiving IDeg.

S. Funakoshi: None. M. Hayashida: None. K. Sawase: None. J. Hashiguchi: None. R. Etoh: None. Y. Mori: None. K. Utsunomiya: None. T. Harada: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.