Dulaglutide vs insulin in adolescents with thalassaemia-induced diabetes: effect on metabolism and atherogenesis (DIADEMA).

What was studied

This open-label trial compared dulaglutide with insulin in teens with diabetes caused by thalassaemia. The teens needed regular transfusions and had iron overload. They were aged 10-18 years and not controlled on metformin. 80 people were randomly assigned to weekly dulaglutide 0.75 mg or to basal-bolus insulin. They were followed for 24 weeks. The main goal was change in glucose swings, measured by CV.

What they found

After 24 weeks, dulaglutide lowered the CV, a measure of glucose swings. It also lowered time above range, fasting glucose, HbA1c, fructosamine, total cholesterol and ferritin. Fasting C-peptide and time in range rose. In the insulin group, the CV and time above range rose. The effect size for the CV gap was 1.69. No serious adverse event was reported.

What it means for patients

The authors said dulaglutide gave greater gains in glucose control and variability than insulin. This was in teens with thalassaemia-induced diabetes. They said safety was not compromised. They said it might help iron overload, insulin release and blood fats. They called the findings exploratory and in need of more study.

Why it is not certain yet

The authors call the findings exploratory. The trial was open-label. It took place at one hospital in Cairo. 80 people took part. Follow-up lasted 24 weeks.

Source

Dulaglutide vs insulin in adolescents with thalassaemia-induced diabetes: effect on metabolism and atherogenesis (DIADEMA).

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