Effect of dulaglutide and long-acting insulin combination therapy in patients with type 2 diabetes: a retrospective observational study.

Objective: The study aimed to evaluate the long-term effects of combination therapy comprising dulaglutide and long-acting insulin, on glycemic control in patients with type 2 diabetes.

Methods: This retrospective observational study included 20 patients with type 2 diabetes who underwent blood glucose management with intensive insulin therapy for a limited period. All patients were switched from intensive insulin therapy to combination therapy comprising dulaglutide and long-acting insulin. Hemoglobin A1c was evaluated before and 4, 12, and 24 weeks after starting combination therapy. Continuous glucose monitoring was conducted before and 1 and 24 weeks after starting combination therapy.

Results: Hemoglobin A1c levels were significantly reduced after 4, 12, and 24 weeks of combination therapy (- 2.2% ± 0.4%,  < 0.0001; - 3.7% ± 0.8%,  = 0.0003; and - 3.6% ± 0.8%,  = 0.0005, respectively). Glycemic variability (% coefficient of variation) was significantly decreased after 1 and 24 weeks of combination therapy (- 5.7% ± 2.1%,  = 0.011; and - 8.7% ± 2.4%,  = 0.003, respectively) and the percentage of readings and time > 250 mg/dL at 24 weeks was significantly improved (- 2.2% ± 0.8%,  = 0.019).

Conclusion: Combination therapy with dulaglutide and long-acting insulin resulted in better blood glucose control than intensive insulin therapy, which persisted for 24 weeks. Combination therapy also reduced blood glucose fluctuations and the number of self-injections needed.

Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-022-00592-z.