Endocrine Abstracts (2017) 49 EP621 | DOI: 10.1530/endoabs.49.EP621

Dulaglutide added on Empagliflozin improves blood pressure, body weight, glycemic control and albuminuria in obese diabetic patients

Carmen Acosta-Calero1, Claudia Arnas-Leon1, Ana Delia Santana-Suarez1, Manuel Nivelo-Rivadeneira1, Agnieszka Kuzior1, Sara Quintana-Arroyo1, Nery Sablon-Gonzalez2 & Francisco Javier Martinez-Martin3


1Endocrinology Department, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain; 2Nephrology Department, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain; 3Outpatient Hypertension Clinic, Hospital Universitario de Gran Canaria Dr. Negrin, as Palmas de Gran Canaria, Spain.


Objective: GLP-1 receptor agonists and SGLT2 inhibitors improve glycemic control, body weight, blood pressure and albuminuria by different pathways. However, their combination is not endorsed by ADA-EASD guidelines, and available data are scarce. Our objective in this open observational study was to elucidate the effect of added Dulaglutide in obese type 2 diabetic patients previously treated with Empagliflozin but insufficiently controlled.

Methods: Dulaglutide 1.5 mg/week was added to the treatment of 20 type 2 diabetic patients with BMI >30 kg/m2 previously treated with Empagliflozin 10 mg/day for at least 3 months but having HbA1C >7%. They were re-evaluated after 3–6 months without additional medication changes, except for insulin dosage adjustments and iDPP4 discontinuation. Besides clinical routine, 24 h. ABPM were performed before and after. Stats were performed by two-tailed paired t-test, *meaning P<0.05. Values are given as mean±S.D.

Results: Age was 49±11 and diabetes duration 8±3 years. 53% were women. Baseline BMI was 34.9±2.5 kg/m2; ABPM: Awake, BP 131±8/85±8 mmHg, HR 74±10 bpm; Sleep, 127±8/78±10 mmHg, 69±10 lpm. Fasting glycemia was 167±46 mg/dl, HbA1C 8.0±0.6%, urate 6.9±1.4 mg/dl, Cr 0.91±0.17 mg/dl, GFR (CKD-EPI estimation) 87.1±16.8 ml/min/1.73 m2, Albuminuria 291±268 mg/gr Cr; median 232, IQR 23-460. At follow-up there were no withdrawals due to side effects, one patient was lost to follow-up and 16% reported mild nausea and/or diarrhoea. Body weight change was −4.0±2.6* kg, BMI −1.37±0.83* kg/m2. ABPM: Awake SBP −4±4*, DBP −1±3 mmHg, HR 1±4 bpm; Sleep, SBP −6±5*, DBP −4±6* mmHg, HR +2±7 bpm. Fasting glycemia change −41±23* mg/dl; HbA1C −1.1±0.6* %, urate −0.12±0.24* mg/dl; Cr −0.04±0.11 mg/dl, GFR +1.9±7.3 ml/min/1.73 m2, albuminuria −71±105* mg/gr Cr (−29±31%).

Conclusions: Dulaglutide added on Empagliflozin in obese type 2 diabetic patients was well tolerated and effective for glycemic control, body weight, blood pressure (particularly nocturnal) and albuminuria.