Diabetologie und Stoffwechsel 2017; 12(01): 50-55
DOI: 10.1055/s-0042-124422
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Real-World-Wirkungen von Dulaglutide bei Patienten, betreut in Diabetologischen Schwerpunktpraxen

Real-World Effects of Dulaglutide on Out-Patients in Diabetes Centers
Rüdiger Göke
1   Diabetes Center Marburg, Germany
,
Cornelia Marck
2   Diabetes Center Pohlheim, Germany
,
Günter Zerth
3   Diabetes Center Oberursel, Germany
,
Ingo Niemetz
4   Diabetes Center Kassel, Germany
,
Christian Klepzig
5   Diabetes Center Offenbach, Germany
› Author Affiliations
Further Information

Publication History

03 October 2016

21 December 2016

Publication Date:
26 January 2017 (online)

Zusammenfassung

Dulaglutide ist ein GLP-1-Rezeptoragonist, der seit Februar 2015 in Deutschland zur Therapie von Menschen mit Diabetes mellitus Typ 2 zur Verfügung steht. Dulaglutide kann mit anderen Antidiabetika inklusive Insulinen kombiniert werden. In dieser Praxisstudie wurden die Effekte von Dulaglutide auf HbA1c und Körpergewicht zu Beginn und nach sechsmonatiger Therapie untersucht. Die Patienten erhielten ab Therapiebeginn einmal wöchentlich 1,5 mg Dulaglutide s. c. Vor Therapiebeginn waren die Patienten bereits mit verschieden Substanzen antidiabetisch behandelt worden. Inkretinbasierte Behandlungen wurden vor Beginn der Therapie mit Dulaglutide abgesetzt; andere Therapien konnten fortgesetzt werden. Die Gabe von Dulaglutide führte zu einer Reduktion des HbA1c-Werts von 8,07 ± 1,36 % auf 6,9 ± 0,9 % (p < 0,0001). Das Gewicht konnte von 109 ± 21,4 kg auf 105 ± 25,1 kg (p < 0,0001) reduziert werden. Der BMI nahm von 37,5 ± 6,48 kg/m2 auf 36,32 ± 0,64 kg/m2 ab (p < 0,0001). Die Zahl der Patienten mit einem HbA1c < 7 % stieg von 19 auf 56 (66 %). Im höchsten HbA1c-Bereich ≥ 9 % sank die Zahl von 27 auf 2 (–93 %). Mit Sitagliptin vorbehandelte Diabetiker profitierten von eine Umstellung auf Dulaglutide (HbA1c: 8,48 ± 1,53 % vs. 6,92 ± 0,99 % (p < 0,0001); Körpergewicht 103 ± 31,1 kg vs. 100,8 ± 31,6 kg (p < 0,05)). Eine Umstellung von mit GLP-1-Rezeptoragonisten vorbehandelten Diabetikern auf Dulaglutide brachte keine Vorteile.

Abstract

Dulaglutide is a GLP-1 receptor agonist which is available in Germany for the treatment of type 2 diabetics since February 2015. Dulaglutide can be combined with other antidiabetics including insulin. In the present study with out-patients, the effects of a six-month treatment with dulaglutide on HbA1c and body weight were examined. From the begin of therapy patients received 1.5 mg dulaglutide s. c. one weekly. Before start of therapy patients had already been treated with various other antidiabetics. Incretin-based therapies were stopped before treatment with dulaglutide; other therapies could be continued. Application of dulaglutide resulted in a decrease of HbA1c levels from 8.07 ± 1.36 % to 6.9 ± 0.9 % (p < 0.0001). Body weight was reduced from 109 ± 21.4 kg to 105 ± 25.1 kg (p < 0.0001). BMI declined from 37.5 ± 6.48 kg/m2 to 36.32 ± 0.64 kg/m2 (p < 0.0001). The number of patients with a HbA1c < 7 % increased from 19 to 56 (66 %). In the highest HbA1c range ≥ 9 % the number declined from 27 to 2 (–93 %). Diabetics pretreated with sitagliptin showed a benefit of the change to dulaglutide (HbA1c: 8.48 ± 1.53 % vs. 6.92 ± 0.99 % (p < 0.0001); body weight 103 ± 31.1 kg vs. 100.8 ± 31.6 kg (p < 0.05)). A conversion of diabetics pretreated with GLP-1 receptor agonists to dulaglutide did not show any advantage.

 
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