Dulaglutide‐combined basal plus correction insulin therapy contributes to ideal glycemic control in non‐critical hospitalized patients

Abstract

Abstract Aims/Introduction We investigated whether dulaglutide (DU)‐combined conventional insulin therapy is beneficial for glycemic control in non‐critically ill hospitalized patients with type 2 diabetes. Materials and Methods This study was a prospective, randomized controlled pilot study. Participants were randomized to either basal‐plus (BP) therapy, where basal insulin and corrective doses of regular insulin were administered before meals, or BP + DU therapy, where BP therapy was combined with DU. Blood glucose (BG) levels before and after every meal were measured for 7 days after assignment to groups. Because we consider the ideal BG during hospitalization to be within 100–180 mg/dL, we defined this range as the hospitalized ideal glucose range (hIGR). We compared the percentage of BG measurements within the hIGR among all BG measurements (%hIGR), mean BG, glucose variability and insulin dose between the two groups. Results Of 54 patients, 27 were assigned to the BP group and 27 to the BP + DU group. The %hIGR was significantly higher (44% vs 56%, P 240 mg/dL and BG <70 mg/dL was significantly lower in the BP + DU group than in the BP group (both P < 0.001). The mean BG (183 ± 29 vs 162 ± 30 mg/dL, P < 0.05), standard deviation (P < 0.01), coefficient of variation (P < 0.01) and total regular insulin dose (P < 0.05) in the BP + DU group were significantly lower than those in the BP group. No significant side‐effects were observed in either group. Conclusions BP + DU therapy reduced the frequency of hyperglycemia and hypoglycemia, and resulted in a lower glucose variability.

Keywords

• Glucagon‐like peptide‐1 receptor agonist
• Inpatients
• Type 2 diabetes