Dulaglutide 1.5 mg weekly significantly improved HbA1c, fasting blood sugar, weight, and BMI in 205 Saudi patients with type 2 diabetes over 12 months, with nausea and fatigue as the most common side effects.
205 patients with significant improvements at 6 and 12 monthsDespite 33% having diabetes for over 20 years and 41% having severe obesity, dulaglutide still delivered meaningful improvements in blood sugar control and weight
What the researchers found
In this cohort of 205 patients, dulaglutide 1.5 mg weekly produced significant improvements in multiple outcomes at both 6 and 12 months compared to baseline. Weight, BMI, HbA1c, and fasting blood sugar all improved significantly.
The patient population was notable for the severity and duration of their disease: approximately 33% had diabetes for more than 20 years and 41.4% had class III (severe) obesity. Despite this challenging patient profile, dulaglutide delivered meaningful glycemic and weight benefits. Side effects were predominantly gastrointestinal, with nausea (52%) and fatigue (28%) being the most commonly reported.
Why it matters
Most clinical trials of GLP-1 receptor agonists are conducted in Western populations, so real-world data from Middle Eastern populations is valuable for understanding how these drugs perform across different ethnicities, diets, and healthcare settings. Saudi Arabia has one of the highest diabetes prevalence rates globally, making effective treatment data from this population particularly relevant to regional clinical practice.
How the study worked
This was a retrospective single-arm cohort study conducted at endocrine and diabetic outpatient clinics at King Saud Medical City in Riyadh. Researchers used purposive sampling to recruit 205 type 2 diabetes patients on dulaglutide. Data were collected from medical records and through phone-based interview questionnaires. Outcomes were assessed at baseline, 6 months, and 12 months of therapy.
What this study cannot tell us
This was a retrospective, single-arm study without a control group, so improvements cannot be definitively attributed to dulaglutide versus other concurrent treatments or lifestyle changes. Purposive (non-random) sampling may introduce selection bias. Data relied partly on phone interviews, which are subject to recall bias. The study was conducted at a single center in Riyadh, limiting generalizability even within Saudi Arabia. Specific numerical changes in HbA1c, weight, and other measures were not provided in the abstract.
How to read the evidence
This is a retrospective observational cohort study without a control group, placing it in the lower tiers of clinical evidence. While the sample size of 205 patients is reasonable, the lack of randomization, blinding, and a comparator arm limits causal conclusions.
When this study was published
Published in 2024, this is a very recent real-world effectiveness study reflecting current clinical use of dulaglutide in a Saudi healthcare setting.
The bigger picture
GLP-1 receptor agonists have become one of the most important drug classes in diabetes and obesity management. While large randomized controlled trials like AWARD established dulaglutide's efficacy, real-world studies like this one from Saudi Arabia help confirm that benefits translate outside of clinical trial settings and across diverse populations. The high nausea rate (52%) aligns with the known GI side effect profile of GLP-1 drugs and is an important consideration for patient counseling and adherence.
Questions still open
- How does dulaglutide's real-world effectiveness in Saudi populations compare to its performance in the AWARD clinical trial program?
- What strategies could reduce the 52% nausea rate — slower dose titration, timing of administration, or dietary modifications?
- Does the long duration of diabetes (>20 years in a third of patients) affect the degree of response to dulaglutide compared to patients with earlier-stage disease?
Common questions
What is dulaglutide and how does it work?
Is nausea from dulaglutide a serious concern?
Read the original research
Efficacy and Safety of Injectable Dulaglutide 1.5 mg Among Type 2 Diabetes Patients in Clinics at King Saud Medical City, Riyadh, Saudi Arabia.
Journal of epidemiology and global health, 14(3), 720-729
Citation
Albargawi, Mashael Saad; Alharbi, Rawan Naser; Alajlani, Mohammad Abbas; Abdulaal, Ibtihal Abdulwarith; Aldakhil, Lina Othman. (2024). Efficacy and Safety of Injectable Dulaglutide 1.5 mg Among Type 2 Diabetes Patients in Clinics at King Saud Medical City, Riyadh, Saudi Arabia.. Journal of epidemiology and global health, 14(3), 720-729. https://doi.org/10.1007/s44197-024-00207-7