Therapy Simplification with Dulaglutide in Elderly Patients: A Real World Study

Abstract

Prevalence of type 2 diabetes represent an epidemic problem especially for aging of population. Median age of people affected is rising and Internation Diabetes federation suggest that 1 patients of 5 has more than 65 years. Same situation affected also Italy where in 2020 about 20% of T2D patients were older than 70 years old. This class of patients present often-severe comorbidity as cardiovascular and kidney impairment and are undergoing complex therapies with multiple daily therapy intakes and difficulties in adherence to prescribed therapy. New developed drug, as GLP1-receptor agonist, like Dulaglutide (DU), may be useful in elderly for drug’s ancillary effects and for demonstrated safety on hypoglycemic events. Nevertheless, majority of knowledge, derived from RCT-study, enrolled patients aged 20-65 years and data in elderly patients are limited. Data from real world experience could be useful to understand safety and efficacy of this drug. We retrospectively analyzed data from 751 T2D patients to evaluate DU after 6, 12 and 18 months, comparing people older and younger than 70 years. The introduction of DU, with a relevant number of insulin and sulphanilureas suspensions,statistically reduced HbA1C and body weight after 6 months while glomerular filtration rate (GFR) remained stable and these results lasted over time.About 23% patients dropped-out (8% for gastrointestinal disturbances). No significative differences in tolerability and efficacy, between the two groups were found. DU is a safe, efficacious and easy to use option even for elderly T2D patients.