Dulaglutide Beat Insulin Glargine in Type 2 Diabetes

BOSTON — Once-weekly dulaglutide yielded significantly greater reductions in HbA1c, as compared with insulin glargine, in patients with type 2 diabetes, according to data presented at the American Diabetes Association (ADA) 75th Scientific Sessions.

In the open-label, multinational, parallel-arm study, researchers compared the safety and efficacy of once-weekly dulaglutide 1.5 mg and 0.75 mg to once-daily insulin glargine in patients with type 2 diabetes that is uncontrolled by metformin and/or a sulfonylurea.

They randomly assigned 789 patients (83.9% Asian; mean HbA1c, 8.36%; mean weight, 73.8 kg) to dulaglutide 1.5 mg, dulaglutide 0.75 mg or insulin glargine.

After 26 weeks, both doses of dulaglutide were superior to insulin glargine for reducing HbA1c. Results showed that HbA1c decreased 1.7% from baseline in the dulaglutide 1.5-mg group, 1.32% in the dulaglutide 0.75-mg group vs. 1.15% in the insulin glargine group.

Additionally, 65% of patients taking dulaglutide 1.5 mg and 54% of those taking dulaglutide 0.75 mg achieved target HbA1c levels of less than 7%, as compared with 41% of those taking insulin glargine.

Dulaglutide also appeared to have positive effects on weight, with patients being treated with dulaglutide 1.5 mg and 0.75 mg losing an average of 1.51 kg and 0.88 kg, respectively. In contrast, patients treated with insulin glargine gained 0.96 kg, according to the data.

Dulaglutide was generally well tolerated. Incidence of total hypoglycemia was lower in both dulaglutide groups than in the insulin glargine group. No severe hypoglycemia was reported.

Other adverse events were primarily gastrointestinal. More patients taking dulaglutide 1.5 mg and 0.75 mg, compared with insulin glargine, experienced diarrhea (15.2% and 8.4% vs. 1.6%) and nausea (8.7% and 4.9% vs. 0.8%).

“Once-weekly dulaglutide is an effective and safe alternative to once-daily insulin glargine in patients with [type 2 diabetes] taking metformin and/or a sulfonylurea who fail to achieve optimal glycemic control,” the researchers concluded.