BACKGROUND Glucocorticoid (GC)-induced hyperglycemia is characterized by elevated postprandial blood glucose, which commonly requires multiple insulin injections. We investigated whether a long-acting glucagon-like peptide-1 receptor agonist, dulaglutide (Dula), safely improved GC-induced hyperglycemia in inpatients, to reduce insulin injection frequency. METHODS The data of hospitalized patients with GC-induced hyperglycemia treated with Dula (Dula group, n = 38) or without (non-Dula group, n = 38) were retrospectively evaluated. Baseline data were collected at the beginning of GC treatment. The primary outcome in this study was glycemic control, which was compared between the groups using the six-point blood glucose (before and 2 h after each meal) profiles at discharge. The daily injection frequency of injectable drugs at discharge were also compared between groups. RESULTS No specific trend of underlying diseases was observed between the non-Dula and Dula groups. The proportion of patients previously administered with GC pulse therapy was comparable between the two groups. No significant differences were observed between groups, in the starting maintenance GC dose, GC dose at pretreatment of Dula and discharge, and cumulative GC dose during the observation. Six-point blood glucose levels at pretreatment and discharge were comparable between the two groups. However, daily injection frequency of injectable drugs and insulin dose were significantly lower in the Dula group than that in the non-Dula group. No differences were observed in the number of hypoglycemic events, the elevation of serum pancreatic enzyme levels, or gastrointestinal adverse events. CONCLUSION These findings suggest that Dula could provide glycemic control while reducing the insulin dose and injection frequency in inpatients with GC-induced hyperglycemia. The occurrence of adverse events such as gastrointestinal symptoms and hypoglycemia did not increase in the Dula-treated patients compared to those not treated, suggesting its safety.

中文翻译：

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杜拉鲁肽可改善糖皮质激素引起的住院治疗中的高血糖症，并减少胰岛素的剂量和注射频率。

背景技术糖皮质激素（GC）引起的高血糖症的特征在于餐后血糖升高，这通常需要多次胰岛素注射。我们调查了长效胰高血糖素样肽1受体激动剂dulaglutide（Dula）是否可以安全地改善住院患者GC引起的高血糖症，以减少胰岛素注射的频率。方法回顾性分析Dula组（Dula组，n = 38）或不使用Dula组（非Dula组，n = 38）治疗的GC引起的住院高血糖患者的数据。在GC治疗开始时收集基线数据。这项研究的主要结果是血糖控制，使用出院时的六点血糖（每餐前和餐后2小时）比较两组之间的血糖。两组之间还比较了出院时注射药物的每日注射频率。结果在非杜拉族和杜拉族之间没有发现潜在疾病的特定趋势。两组之前接受过GC脉冲疗法的患者比例相当。两组之间在开始维持GC剂量，Dula预处理和出院前的GC剂量以及观察期间的累积GC剂量之间均未观察到显着差异。两组在预处理和出院时的六点血糖水平相当。然而，Dula组的每日注射药物频率和胰岛素剂量明显低于非Dula组。在降血糖事件的数量上没有观察到差异，血清胰酶水平升高或胃肠道不良事件。结论这些发现表明，杜拉可以在血糖升高的住院患者中提供血糖控制，同时降低胰岛素剂量和注射频率。与未治疗的患者相比，接受Dula治疗的患者的胃肠道症状和低血糖等不良事件的发生率没有增加，表明其安全性。