Dulaglutide better vs. insulin glargine, glimepiride for Chinese adults aiming to lower HbA1c without weight gain, hypoglycemia
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More Chinese adults with type 2 diabetes reduced their HbA1c to below 7% while not gaining weight or experiencing hypoglycemia when assigned dulaglutide vs. glimepiride or insulin glargine, according to findings published in the Journal of Diabetes Investigation.
“Effective patient-centered strategies for the treatment of type 2 diabetes should balance the benefits of glycemic control and the threat of weight gain and hypoglycemia,” Zhiguang Zhou, MD, PhD, of the department of metabolism and endocrinology at the Second Xiangya Hospital and Central South University in Changsha, China, and colleagues wrote.
Zhou and colleagues evaluated how frequently participants in the AWARD-CHN1 and AWARD-CHN2 trials were able to avoid weight gain and hypoglycemia while reducing HbA1c below 7%. The AWARD-CHN1 trial included 184 Chinese adults treated with 1.5 mg dulaglutide (Trulicity, Eli Lilly) for 26 weeks (mean age, 52.8 years; 41% women), 186 Chinese adults treated with 0.75 mg dulaglutide for 26 weeks (mean age, 53.8 years; 42% women) and 186 Chinese adults treated with glimepiride for 26 weeks (mean age, 52.7 years; 41% women). The AWARD-CHN2 trial included 200 Chinese adults treated with 1.5 mg dulaglutide for 52 weeks (mean age, 54.5 years; 42% women), 196 Chinese adults treated with 0.75 mg dulaglutide for 52 weeks (mean age, 54.1 years; 39% women) and 195 Chinese adults treated with glimepiride for 52 weeks (mean age, 55 years; 37% women).
AWARD-CHN1 trial
Among those treated with 1.5 mg dulaglutide in the AWARD-CHN1 trial, 47.8% reduced HbA1c below 7% while avoiding weight gain and hypoglycemia at 26 weeks vs. 19.9% of those treated with glimepiride (P < .001). Similarly, 39.2% of those treated with 0.75 mg dulaglutide reduced HbA1c below 7% while avoiding weight gain and hypoglycemia at 26 weeks (P < .001 vs. glimepiride).
When assessing only whether participants had no weight gain in addition to HbA1c reductions below 7%, the researchers found that among those treated with 1.5 mg dulaglutide, 50% of participants met this threshold while 28.5% of those treated with glimepiride did so (P < .001). Among those treated with 0.75 mg dulaglutide, 40.3% met the threshold (P < .005 vs. glimepiride).
When assessing only whether participants had no hypoglycemia in addition to HbA1c reductions below 7%, the researchers found that among those treated with 1.5 mg dulaglutide, 68.5% of participants met this threshold while 42.5% of those treated with glimepiride did so (P < .001). Among those treated with 0.75 mg dulaglutide, 62.4% met the threshold (P < .001 vs. glimepiride).
AWARD-CHN2 trial
In the AWARD-CHN2 trial, among those treated with 1.5 mg dulaglutide, 26% reduced HbA1c below 7% while avoiding weight gain and hypoglycemia at 52 weeks vs. 6.7% of those treated with insulin glargine (P < .001). Similarly, 23% of those treated with 0.75 mg dulaglutide reduced HbA1c below 7% while avoiding weight gain and hypoglycemia at 52 weeks (P < .001 vs. insulin glargine).
When assessing only whether participants had no weight gain in addition to HbA1c reductions below 7%, the researchers found that among those treated with 1.5 mg dulaglutide, 36.5% of participants met this threshold while 10.8% of those treated with insulin glargine did so (P < .001). Among those treated with 0.75 mg dulaglutide, 40.3% met the threshold (P < .005 vs. insulin glargine).
When assessing only whether participants had no hypoglycemia in addition to HbA1c reductions below 7%, the researchers found that among those treated with 1.5 mg dulaglutide, 40% of participants met this threshold while 17.4% of those treated with insulin glargine did so (P < .001). Among those treated with 0.75 mg dulaglutide, 35.2% met the threshold (P < .001 vs. insulin glargine).
“Dulaglutide is an effective therapeutic alternative for Chinese type 2 diabetes patients,” the researchers wrote. “Compared with glimepiride or insulin glargine, significantly greater proportions of patients on dulaglutide attained the HbA1c target of < 7% without weight gain or hypoglycemia. These outcomes are similar to global studies with dulaglutide and studies with the other GLP-1 receptor agonist class.” – by Phil Neuffer
Disclosures: The study was sponsored by Eli Lilly. Zhou reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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