Dulaglutide reduced HbA1c by 1.65% and body weight by 2.62 kg over 24 weeks in 3,291 Chinese T2DM patients in routine clinical practice, with a safety profile consistent with clinical trials.
HbA1c -1.65% in real-world practiceFirst prospective real-world GLP-1 RA study in Chinese T2DM patients, confirming clinical trial-like effectiveness across 46 hospitals
What the researchers found
In 3,291 Chinese adults with T2DM prescribed dulaglutide in routine clinical practice (46 hospitals, 2020-2021):
- HbA1c: -1.65% from baseline at 24 weeks (p<0.001)
- Body weight: -2.62 kg from baseline at 24 weeks (p<0.001)
- TEAEs: Reported in 40.5% — nausea (5.9%), diarrhea (5.6%), decreased appetite (5.4%)
- Serious AEs: 4.9% of patients
- Treatment discontinuation due to AEs: 6.4%
Greater HbA1c reductions seen in patients with:
- T2DM duration ≤5 years (p=0.002)
- Baseline HbA1c ≥8.5% (p<0.001)
- No atherosclerotic cardiovascular disease (p=0.002)
Why it matters
Clinical trial data doesn't always predict real-world performance, especially across different ethnic populations. This first GLP-1 RA real-world study in Chinese patients confirms dulaglutide works effectively in everyday clinical practice in China — important given the country's enormous diabetes burden (140+ million people).
How the study worked
Prospective, observational, post-marketing study at 46 hospitals in China. Adults with T2DM prescribed dulaglutide in routine practice were followed for up to 24 weeks. Primary endpoint: TEAE and serious AE incidence. Exploratory endpoints: HbA1c and body weight changes. Post hoc subgroup analyses and multivariate regression identified predictors of response.
What this study cannot tell us
This is an observational study without a control group, so improvements cannot be definitively attributed to dulaglutide alone. Not all patients completed the 24-week follow-up. HbA1c and weight data were patient-reported, which may introduce measurement variability. The study was industry-sponsored (Eli Lilly). Only dulaglutide was studied; comparisons with other GLP-1 RAs were not possible.
How to read the evidence
This is a large prospective observational post-marketing study (n=3,291) providing real-world evidence. While it lacks a control group, the large sample size and multi-center design provide valuable complementary evidence to prior RCTs.
When this study was published
Published in 2023 with data from 2020-2021, this study provides current real-world evidence for dulaglutide in the Chinese population.
The bigger picture
China has the world's largest diabetes population, and GLP-1 agonist adoption has been growing rapidly. This post-marketing study provides essential evidence for Chinese healthcare authorities and clinicians about dulaglutide's real-world performance, supporting its continued use and potentially informing insurance coverage decisions in the Chinese healthcare system.
Questions still open
- How does dulaglutide's real-world performance in Chinese patients compare to semaglutide or tirzepatide?
- Do the predictors of better response (shorter diabetes duration, higher baseline HbA1c) inform clinical decision-making?
- Would longer follow-up reveal different safety or efficacy patterns?
Common questions
Does dulaglutide work as well in everyday practice as in clinical trials?
Who benefits most from dulaglutide?
Read the original research
Safety and effectiveness of dulaglutide in Chinese adults with type 2 diabetes mellitus in a real-world setting: A prospective, observational post-marketing study.
Diabetes, obesity & metabolism, 25(12), 3578-3588
Citation
Guo, Lixin; Li, Li; Yu, Qiurong; Wang, Na; Chen, Jun; Xi, Yue; Wang, Huan; Wang, Yihua; Xu, Jiawei. (2023). Safety and effectiveness of dulaglutide in Chinese adults with type 2 diabetes mellitus in a real-world setting: A prospective, observational post-marketing study.. Diabetes, obesity & metabolism, 25(12), 3578-3588. https://doi.org/10.1111/dom.15252