1060-P: Effect of Dulaglutide and Long-Acting Insulin Combination Therapy in Patients with Type 2 Diabetes

Objective: Glucagon-like peptide-1 receptor agonists (GLP-1-RA) are assumed to decrease the number of injections and improve blood glucose control in patients with type 2 diabetes (T2D). We aimed to evaluate the effects of switching from multiple daily insulin injection therapy (MDI) to combination therapy involving a long-acting GLP-1-RA, dulaglutide, and long-acting insulin on glycemic control.

Methods: We examined patients with T2D who admitted to our department and underwent blood glucose management with MDI, followed by flash glucose monitoring. The treatment was subsequently switched to dulaglutide + long-acting insulin combination therapy. We evaluated the blood glucose excursion after MDI and 1 and 24 weeks after dulaglutide + long-acting insulin combination therapy. Furthermore, we evaluated hemoglobin A1c (HbA1c) after 12 and 24 weeks of dulaglutide + long-acting insulin combination therapy.

Results: We enrolled 20 patients (mean age: 68.6 ± 11.7 years; HbA1c value: 10.1% ± 2.8%; previous MDI: n = 4). Mean blood glucose levels after MDI and 1 and 24 weeks after dulaglutide + long-acting insulin combination therapy were 124.8 ± 35.6, 122.5 ± 30.4, and 119 ± 21.3 mg/dl, respectively. Blood glucose level was significantly lower 24 weeks after dulaglutide + long-acting insulin combination therapy than shortly after MDI (P = 0.0048). Furthermore, blood glucose excursion tended to decrease after switching to dulaglutide + long-acting insulin combination therapy. After 12 and 24 weeks of the switch, HbA1c value significantly decreased (−3.6% ± 0.78%, P = 0.0003 and −3.7% ± 0.78%, P = 0.0002, respectively).

Conclusions: The switch from MDI to dulaglutide + long-acting insulin combination therapy resulted in better blood glucose control, with reductions in blood glucose excursion and the number of self-injections; moreover, the effects continued for 24 weeks.