Objective: This study aims to evaluate the changes in estimated glomerular filtration rate (eGFR) and glycosylated hemoglobin (HbA1c) together with waist-to-hip ratio (WHR) and body weight (BW) in Indian patients with type 2 diabetes (T2D) treated with once weekly dulaglutide in a real-world setting.
Methodology: Patients with inadequately controlled T2D (N = 41) from a tertiary care center in India were treated with once weekly dulaglutide as an add-on medication to oral antidiabetics (OADs) with or without insulin (mean eGFR [standard deviation [SD]]: 76.11 [20.23] mL/minute in patients with <120 mL/min/1.73 m2; mean HbA1c [SD]: 9.33 [1.18] %; mean WHR [SD]: 0.96 [0.06]; mean BW [SD]: 82.44 [14.55] kg; mean BMI [SD]: 31.19 [4.29] kg/m2). A total of 5 patients presented with glomerular hyperfiltration (eGFR>120 mL/min). Improvements in eGFR, HbA1c, WHR, and BW from baseline to 6-month follow-up were analyzed using paired t test.
Results: Follow-up of 6 months with dulaglutide therapy was associated with a significant increase (P<.001) in eGFR (for patients with baseline eGFR ≤120 mL/min) with a mean increase ± standard error of the mean (SEM) of 10.39 ± 1.58 mL/min. Moreover, patients with glomerular hyperfiltration demonstrated a reduction in eGFR with a mean reduction (MR) ± SEM of 37.20 ± 1.64 mL/minute that was statistically not significant. A significant reduction (P<.001) in HbA1c, 2.45 ± 0.11% was demonstrated. In addition, a significant reduction in WHR, BW, and BMI with MR ± SEM of 0.050 ± 0.004, 6.30 ± 0.39 kg, and 2.90 ± 0.22 kg/m2, respectively was demonstrated. Adverse events (AEs) reported include nausea (n = 9), loose stools (n = 2), and loss of appetite (n = 2) that were managed with probiotics and rabeprazole as required.
Conclusion: In a real-world setting, dulaglutide as add-on therapy was well tolerated and significantly improved renal function and glycemic control along with WHR and BW in Indian patients with T2D.
S.A. Patange: None.
