Real-World Evidence of Long-Term Dulaglutide Use: Sustained Glycemic and Weight Improvements Beyond Three Years.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease that requires long-term glycemic control. The long-term real-world evidence for glucagon-like peptide-1 receptor agonists remains limited. This study aimed to evaluate the sustained glycemic and weight-lowering effects of dulaglutide in patients with T2DM who had maintained therapy for at least 3 years. METHODS: This retrospective cohort study analyzed 403 patients with T2DM who were treated continuously with weekly doses of dulaglutide for ≥ 3 years between 2016 and 2023 at a single tertiary hospital. Baseline and follow-up data on glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body weight were also assessed. RESULTS: The participants had a mean age of 60.0 years, with a mean diabetes duration of 17.4 years. Over a mean follow-up of 4.3 years, HbA1c decreased from 8.7% (72 mmol/mol) to 7.6% (60 mmol/mol), reflecting a mean reduction of 1.1% (12 mmol/mol) (p < 0.001), and body weight decreased by 2.9 kg (p < 0.001). Baseline HbA1c level was the strongest predictor of glycemic improvement. CONCLUSIONS: Dulaglutide provided durable improvements in glycemic control and weight reduction for more than 3 years, even in patients with long-standing T2DM and comorbidities. These results support its role as a long-term treatment option in real-world clinical practice.