Effect of dulaglutide injection on weight beyond glycemic control: Real-world observational study

Dulaglutide is an effective Glucagon-like Peptide-1 (GLP-1) Receptor Agonist (RA) in optimizing weight and glycemic control in obese patients with Type 2 Diabetes Mellitus (T2DM). The study's objective was the real-world evaluation of the metabolic effect of Dulaglutide on weight and glycemic control in patients with T2DM from Southern Iraq. This study is a six-month observational prospective longitudinal evaluation of 185 obese individuals with T2DM. They were initiated on Dulaglutide as an add-on drug with Oral Antidiabetic (OAD) or insulin therapy. General characteristics of the patients, glycated hemoglobin (HbA1c), blood glucose, lipid profile, and side effects profile were evaluated at the enrollment and the end of the study. The enrolled 185 obese patients with T2DM, had a T2DM duration (2 -14 years) and initial HbA1c range (6 - 19.5%), with different treatment modalities, including insulin, OADs, or both. The study showed a significant reduction in weight, HbA1c, and serum cholesterol, with minimal hypoglycemic events in 5% of patients (n=9). The gastrointestinal side effects were mild to moderate and self-limited in >96% of patients (n=178), while they were so severe in 4% (n=7) and caused discontinuation of Dulaglutide. Therefore, the insulin regimen was either stopped (n=28), changed (n=7), or reduced (n=9). No change on oral medications was performed in 141 patients. In conclusion, Dulaglutide 1.5 mg administered once a week significantly reduced the weight, HbA1c, Self-Monitoring of Blood Glucose (SMBG), and cholesterol levels with minimal hypoglycemic risk.