Despite increasing awareness and new developments in the treatment and prevention of diabetes, there has been a rapid increase in the number of people with T2D.²

Tight glycemic control may reduce the risk of diabetes complications in people with T2D.³

Non-adherence to treatment is a barrier to effective care. Only 50% adherence to long-term therapy exists among patients with chronic diseases in developed* countries.4

*The magnitude and impact of poor adherence in developing countries is assumed to be even higher

Additionally, clinical inertia can be encountered at any step in T2D management and can delay appropriate treatment intensification for both oral anti-diabetic agents and injectable therapy.5

AWARD: A clinical trial programme spanning the continuum of care

Monotherapy
AWARD 3(6) Dulaglutide vs metformin
Drug-naive or washout from 1 OAM
2-drug combinations
AWARD 5(7) Dulaglutide vs sitagliptin
Add-on to metformin
AWARD 6(8) Dulaglutide vs liraglutide
Add-on to metformin
AWARD 8(9) Dulaglutide vs placebo
Add-on to glimepiride
3-drug combinations
AWARD 1(10) Dulaglutide vs exenatide
Add-on to metformin and pioglitazone
AWARD 2(1) Dulaglutide vs insulin glargine
Add-on to metformin and glimepiride
AWARD 10(11) Dulaglutide vs placebo
Add-on to SGLT2 inhibitors with or without metformin
More complex insulin strategies
AWARD 4(12) Dulaglutide vs insulin glargine
Both with mealtime insulin lispro with or without metformin
AWARD 9(13) Dulaglutide vs placebo with insulin glargine
with or without metformin
AWARD 7(14) Dulaglutide vs insulin glargine
Add-on to prandial lispro
AWARD-2 Trial Summary
Research Design and Method
Table adapted from Giorgino F, et al. Diabetes Care. 2015;38: 2241−2249.
Results
HbA1c (%) reduction from baseline at 52 weeks only
Figure adapted from Giorgino F, et al. Diabetes Care. 2015;38: 2241−2249. Results for Dulaglutide 0.75 mg has been excluded
Weight change from baseline to week 78
Graph adapted from Giorgino F, et al. Diabetes Care. 2015;38: 2241−2249. Results for Dulaglutide 0.75 mg has been excluded.
Key Adverse Events
Table adapted from Giorgino F, et al. Diabetes Care. 2015;38: 2241−2249. Results for Dulaglutide 0.75 mg has been excluded.
Conclusions
In this 78-week open-label study, once-weekly dulaglutide 1.5 mg was more effective in reducing HbA1c than glargine in patients with T2D treated with maximally tolerated doses of metformin and sulphonylurea and was associated with body weight loss and a lower risk of hypoglycemia. An optimal balance between benefit in glycemic control and risk of hypoglycemia is of critical importance when considering options for advancing to injectable therapy in patients with T2D uncontrolled on OAMs.
References:
1. Giorgino F, et al.Diabetes Care. 2015;38:2241−2249.
2. International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation, 2017.
3. Stratton IM, Adler AI, Neil AW, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes. (UKPDS 35): prospective observational study. BMJ. 2000;321(7258): 405−412.
4. World Health Organization. Adherence to long-term therapies – evidence for action. 2003 WHO website. http://apps.who.int/medicinedocs/en/d/Js4883e/6.html. Accessed 7 November 2017.
5. Khunti S, Davies MJ, et al. Clinical inertia in the management of type 2 diabetes mellitus: a focused literature review. Br J Diabetes Vasc Dis. 2015; 15(2):65−69.
6. Umpierrez G, et al. Diabetes Care. 2014;37:2168−2176.
7. Nauck M, et al. Diabetes Care. 2014;37:2149−2158.
8. Dungan KM, et al. Lancet. 2014;384:1349−1357.
9. Dungan KM, et al. Diabetes Obes Metab. 2016;18:475−482.
10. Wysham C, et al. Diabetes Care. 2014;37:2159−2167.
11. Ludvik B, et al. Lancet Diabetes Endocrinol. 2018;6:370−381
12. Blonde L, et al. Lancet. 2015;385:2057−2066.
13. Pozzilli P, et al. Diabetes Obes Metab 2017;19:1024−1031.
14. Tuttle KR, et al. Lancet Diabetes Endocrinol. 2018;6:605−617.

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