The Effects of Once-Weekly Dulaglutide and Insulin Glargine on Glucose Fluctuation in Poorly Oral-Antidiabetic Controlled Patients with Type 2 Diabetes Mellitus

Biomed Res Int. 2019 Dec 24:2019:2682657. doi: 10.1155/2019/2682657. eCollection 2019.

Abstract

Aim. To compare the effects of once-weekly Dulaglutide with once-daily glargine in poorly oral-antidiabetic controlled patients with type 2 diabetes mellitus (T2DM). Method. A total of 25 patients with T2DM admitted into Department of Endocrinology from December 2012 to August 2013 were randomly assigned into two groups: Dulaglutide group (n = 16) and glargine group (n = 9). All patients received either Dulaglutide or glargine treatments for 52 weeks. Continuous glucose monitoring systems (CGMS) were applied to them for two 72 h periods at before and after the treatment each. Patient general clinical data were collected and analyzed. Result. Fast blood glucose (FBG) of the glargine group declined more significantly than the Dulaglutide group after treatment (p < 0.05). The mean blood glucose (MBG), standard deviation of blood glucose (SDBG), mean amplitude of glycemic excursion (MAGE) within a day, the largest amplitude of glycemic excursion (LAGE), M-value, absolute means of daily difference (MODD) of glycemic excursion, the percentage of time (≤2.8 mmol/L, ≤3.9 mmol/L, ≥10.0 mmol/L, ≥13.9 mmol/L, 3.9-7.8 mmol/L, and 9-10.0 mmol/L), maximum glycemic value, and minimum glycemic value were similar between the two groups (p > 0.05). The incidence of hypoglycemia was also similar between the two groups (p > 0.05). Though serum levels of TNF-α, IL-6, and 8-PGF2α all decreased, significant reduction was found in TNF-α and 8-PGF2α. TNF-α was only significantly reduced in the Dulaglutide group, while 8-PGF2α was seen in both groups. Conclusion. For T2DM patients with poorly controlled oral antidiabetic drugs, once-weekly Dulaglutide not only has the same effect on glucose fluctuation as once-daily glargine but also significantly reduced TNF-α and 8-PGF2α after a 52 week treatment protocol. This trial is registered with ClinicalTrials.gov NCT01648582.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Blood Glucose / drug effects
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / genetics
  • Diabetes Mellitus, Type 2 / pathology
  • Dinoprost / genetics
  • Drug Therapy, Combination / adverse effects
  • Female
  • Gene Expression Regulation / drug effects
  • Glucagon-Like Peptides / administration & dosage
  • Glucagon-Like Peptides / adverse effects
  • Glucagon-Like Peptides / analogs & derivatives*
  • Glucose / metabolism
  • Glycated Hemoglobin / genetics
  • Humans
  • Hypoglycemia / drug therapy*
  • Hypoglycemia / genetics
  • Hypoglycemia / pathology
  • Immunoglobulin Fc Fragments / administration & dosage*
  • Immunoglobulin Fc Fragments / adverse effects
  • Insulin Glargine / administration & dosage*
  • Insulin Glargine / adverse effects
  • Interleukin-6 / genetics
  • Male
  • Metformin / administration & dosage
  • Middle Aged
  • Recombinant Fusion Proteins / administration & dosage*
  • Recombinant Fusion Proteins / adverse effects
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Immunoglobulin Fc Fragments
  • Interleukin-6
  • Recombinant Fusion Proteins
  • Tumor Necrosis Factor-alpha
  • hemoglobin A1c protein, human
  • Insulin Glargine
  • Glucagon-Like Peptides
  • Metformin
  • Dinoprost
  • Glucose
  • dulaglutide

Associated data

  • ClinicalTrials.gov/NCT01648582