Attenuated Efficacy of Dulaglutide in Elder Type 2 Diabetes Mellitus (T2DM) Cases
The acute increase in type 2 diabetes mellitus is one of the most serious medical problems today.
T2DM patients were about 385 million in 2014 and increase to 592 million by
2035.
Furthermore, the global health expenditure for diabetes has been approximately 11% of
total medical spending on adults in the world.
T2DM is characteristic for the deterioration of pancreatic β-cell function
and insulin resistance in the liver and peripheral tissues.
A combination of these factors, T2DM has an overproduction of hepatic blood glucose,
elevation of fasting blood glucose, and insufficient glucose uptake by muscle cells which
would increase postprandial blood glucose.
Furthermore, several pathophysiological impairments have played a role in the progression
and development of T2DM, such as liver, muscle, dysfunction of pancreatic α-cells
with elevated glucagon value, fat cells with accelerated lipolysis and kidney
with increased glucose reabsorption.
T2DM has a chronic elevation of blood glucose levels, resulting in microvascular
complications with neuropathy, retinopathy, nephropathy, and macrovascular
complications with ischemic heart disease, cerebrovascular disease, peripheral arterial disease.
Therefore, clinical research and therapy have been continued for the achievement
of optimal glycemic control associated with optimal management of body weight,
blood pressure, and lipid levels for years.
Recently, several new anti-diabetic medicines have been developed.
They have some beneficial effects for lowering HbA1c, body weight, hypoglycemia incidence and others.
Diabetes Res Open J. 2018; 4(1): 1-8. doi: 10.17140/DROJ-4-136