Effectiveness of dulaglutide in the real world and in special populations of type 2 diabetic patients

Context: In randomized controlled trials (RCTs) on type 2 diabetes (T2D) patients, the glucagonlike peptide-1 (GLP-1) receptor agonist (GLP-RA) dulaglutide reduced HbA1c and body weight, but generalizability of such findings to real-world T2D patients is challenging. Objective: We evaluated effectiveness of dulaglutide in routine clinical practice, especially in subgroups of patient that are underrepresented in RCTs. Design: Retrospective multicenter study. Setting: Diabetes outpatient clinics. Patients and intervention: All consecutive patients who initiated dulaglutide between 2015 and 2018. Main outcome measures: Changes in HbA1c and body weight were assessed up to 30 months after baseline. Effectiveness was analyzed in patient subgroups according to: prior use of GLP- 1RA, persistence on treatment and dose, age, sex, disease duration, renal function, obesity, cardiovascular disease, or concomitant use of insulin or sulphonylurea. Results: From a background population of 83,116 pati...