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Category: Volume 15, Issue 2, 2021
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Type 2 diabetes is a chronic progressive metabolic disease requires continues intensification of treatment in order to prevent its long-term complications, the use of GLP-1RA in combination with Ant hyperglycemic drugs  has provided potent glucose lowering effect with less weight gain and hypoglycemia.Aim of the study:To study the effectiveness and safety of Trulicity (Dulaglutide) when added to existing therapy of obese Type 2 diabetes patient with poorly controlled long duration diabetes.Methods: Longitudinalstudycarried out among adult T2DM persons attending the Outpatients’ Department, National Centre for Diabetes Tripoli, Libya according to selection criteria. At the initial visit, patient vital parameters (Weight, BMI,Pulseand BP) and biochemical parameters related to the study taken. Patients followed monthly, and study parameters assessed after 3moths and 6 months.Results: 40 patient included in the study (34 Female85%, 6 Males 15%), mean Age 55 (±9.90) years , mean diabetes duration 14.7 (± 6.20) year  , mean body weight 99.16 (±14.23) Kg ,mean BMI 38.29  (± 4.73)Kg/m2 ,mean HbA1c 10.08 (±1.17)% , mean total insulin dose 61.2 (±24.22) units  , mean Urea 28.55  ( ± 11.74) mg%, mean Creatinine 0.67 (±0.22  )mg% , mean Total Cholesterol 157 .43 (± 40.32 ) mg% , mean LDL-c96.99 (± 36.92 )mg% , mean Systolic Blood Pressure 136.25 (± 16.28)mmgh , mean Diastolic Blood Pressure 82.62( ± 0.81)mmgh and mean Pulse 75.80 (± 7.92) Beat/min . After 3 months , 6 months of treatment the results respectively as following : The mean HbA1c reduced to 7.60 ±1.12 %  , 7.01 ±0.94 (P value 0.000), body weight decreased to 95.28 ±36.96 Kg , 92.47 ±14.78 Kg (P value 0.000), total insulin dose reduced to 45.26 ±17.1 , 42.94 ±20.86 units (P value 0.000 ). Mean FBG 135.43 ±32.10 mg%, 128.94 ±29.64 mg% (P value 0.010), PPG 161.10 ±42.61, 144.84 ±29.71 mg% (P value 0.050). Conclusion: Adding Trulicity to the existing therapy of obese, long duration Type 2 diabetes patientswith high HbA1c resulted in lowering of HbA1c, weight reduction,and decrease total insulin dose without significant gastrointestinal and hypoglycemiaevents, the study reported significant lowering effects on lipid profile, preserved Kidney function.

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