부산대학교 도서관

Objective: Dulaglutide (DU) has demonstrated non-inferiority vs. liraglutide (LIR) and superiority vs. exenatide BID (EXE) in A1c reduction. No data are available on how GLP-1RAs affect the relative contribution of basal hyperglycemia (BHG) and post-prandial hyperglycemia (PPHG) to overall hyperglycemia (OHG) across A1c categories. Methods: Data from five phase 3 studies (N = 673) were pooled to assess the change in relative contributions of BHG and PPHG to diurnal OHG across different A1c categories after 6 months of treatment intensification with DU 1.5 mg as monotherapy or with oral medication(s) in type 2 diabetes patients . BHG and PPHG were calculated using the area under the curve of the 7-point SMPG profiles. Overall change in BHG for DU vs. LIR and DU vs. EXE was assessed by individual studies. Results: At baseline, relative contributions of BHG increased and PPHG decreased with increasing A1c levels which was maintained after 6 months of treatment with DU despite 1.3% overall mean A1c reduction. At 6 months, the relative contribution of BHG and PPHG were similar between LIR and DU. Relative contribution of BHG was 66.7% (DU) and 66.0% (LIR) at baseline and 55.2% (DU) and 55.9% (LIR) at 6 months. Relative contribution of PPHG was 33.3% (DU) and 34% (LIR) at baseline and 44.8% (DU) and 44.1% (LIR) at 6 months. However, DU had lower BHG but higher PPHG contribution than EXE. Relative contribution of BHG was 63.3 (DU) and 63.1 (EXE) at baseline and 44.7% (DU) and 56.5% (EXE) at 6 months (p <0.001). Relative contribution of PPHG was 36.7% (DU) and 36.9% (EXE) at baseline and 55.3% (DU) and at 43.5% (EXE) at 6 months Conclusion: The trend of relative contribution of PPHG and BHG across A1c categories is similar before and after DU treatment intensification, implying its effect on both BHG and PPHG to lower A1c.