Liraglutide and Dulaglutide Have Comparable HbA1c Reduction in Emirati Patients with T2DM

Glucagon like peptide-1 is responsible for the incretin effect after a meal or an oral glucose load. Patients with type 2 diabetes mellitus have impairment of secretion and action of glucagon like peptide-1. This impairment can be overcome through pharmacological doses of glucagon like peptide-1 analogues. Aim of the Study: This study aimed at evaluation of the effect of treatment with glucagon like peptide-1 analogues;liraglutide and dulaglutide, in Emirati patients with type 2 diabetes mellitus. Glycemic control was the primary end point while the secondary end point was the effect on body mass index, blood pressure, heart rate, serum creatinine, lipid profile and estimated glomerular filtration rate. Patients & Methods: This is a retrospective study including 54 patients with type 2 diabetes mellitus. Patients used Liraglutide or Dulaglutide as add on therapy to oral antidiabetic medications for one year. Thirty-four patients used liraglutide 1.8 mg once daily and 20 patients used dulaglutide 1.5 mg once weekly. All patients were older than 18 years and had estimated glomerular filtration rate (>90 ml/min/1.73 m2). Body mass index, sitting blood pressure and heart rate were collected. Fasting plasma glucose, HbA1c, lipid panel and other biochemical parameters were also collected. Data were analysed before and at 6 and 12 months of glucagon like peptide-1 analogue treatment. Results: At 12 months of treatment, liraglutide significantly reduced fasting plasma glucose (11.3 ± 4 vs 7 ± 1.7, p < 0.001), HbA1c (8.55 ± 1.6 vs 7.18 ± 1.04, p < 0.001) and body mass index (39.4 ± 6.4 vs 37.6 ± 6.7, p < 0.0005). Dulaglutide did not significantly reduce fasting plasma glucose (15.4 ± 3.5 vs 9.5 ± 5.4 mmol/L, p = 0.053), significantly reduced HbA1c (8.84 ± 1.8 vs 7.5 ± 0.79, p = 0.007), body mass index (38.8 ± 6.8 vs 37.2 ± 6.6, p = 0.004) and estimated glomerular filtration rate (123.6 ± 60 vs 104 ± 47.3, p = 0.008). Dulaglutide was more effective in reduction of body mass index than liraglutide. Both drugs did not show significant effect on blood pressure, heart rate or lipid profile. Conclusion: Over a period of one year, liraglutide and dulaglutide produced comparable reduction of HbA1c and hence diabetes control. Both drugs significantly reduced body mass index but this effect was more pronounced with Dulaglutide. Only liraglutide significantly reduced fasting plasma glucose. Dulaglutide significantly reduced estimated glomerular filtration rate. There was no significant effect of liraglutide or dulaglutide on blood pressure, heart rate or lipid profile.

Clinical Predictors of Iron Deficiency Anemia in Emirati Population with T2DM

Aim: To establish the prevalence of iron deficiency anemia and its clinical predictors in Emirati patients with type 2 diabetes. Patients & Methods: 237 patients were included in the study. A full blood count was obtained in addition to routine blood and urine tests for all patients. Hemoglobin level and iron studies were done for diagnosis of anemia. Statistical analysis was done to find out the prevalence and independent predictors of anemia in the study population of Emirati type 2 diabetic patients. Results: Of the studied 237 patients;36.3% had iron deficiency anemia as per the WHO criteria. Independent predictors of iron deficiency anemia were age ≥ 60 years, female gender and wide pulse pressure ≥ 60 mmHg. Hemoglobin level was directly proportionate to e GFR (p < 0.001). Participants with age ≥ 60 years had 4.2 times higher odds to exhibit anemia. Female participants had 1.95 times higher odds to exhibit anemia. Participants with wide pulse pressure ≥ 60 mmHg have 2.4 higher odds to exhibit anemia. Conclusion: Iron deficiency anemia is common in type 2 diabetic patients. Testing the patient for iron deficiency anemia should be considered in type 2 diabetes patients especially with age ≥ 60 years, female patients and those with wide pulse pressure ≥ 60 mmHg.