PSUN188 Evaluating Response to GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus Managed at a Veterans Affairs Hospital

Type 2 diabetes mellitus (T2DM) is a leading cause of morbidity and mortality in people of all ages worldwide. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer an innovative and unique advancement in treatment for T2DM by not only benefiting blood glucose control but also potentially impacting other diabetes-related complications. However, clinical response to GLP-1 RA is not seen in all patient populations. Our goal was to determine the response rate of GLP-1 RA add-on therapy. We performed a retrospective study of veterans with T2DM initiated on any GLP-1 RA from January 1, 2015, to December 31, 2019, for a duration of at least 6 months to assess the response in terms of hemoglobin A1c (A1c), weight, and total daily insulin dose. Baseline characteristics of 332 patients were reviewed to evaluate response rate. Treatment response thresholds included an A1c reduction of at least 0.5%, weight loss of ≥ 3% of pretreatment body weight, and a ≥ 10% reduction in total daily insulin dose (TDD). We then classified veterans into those without a response, or with 1, 2, or all 3 responses based on data 6-12 months after initiating treatment. We considered it a complete response if all 3 categories were fulfilled. Semaglutide (n=141): 10.64% showed a response to A1c alone, 3.55% had weight reduction alone, and 2.84% had insulin reduction alone. 7.09% showed A1c and weight response, 24.82% had A1c and insulin response, and 13.48% had weight and insulin response. A complete response was seen in 33.33% of veterans. Liraglutide (n=131): 18.32% showed a response to A1c alone, 4.58% had weight reduction alone, and 11.45% had insulin reduction alone. 6.11% showed A1c and weight response, 19.08% had A1c and insulin response, and 8.40% had weight and insulin response. A complete response was seen in 25.19% of veterans. Dulaglutide (n=57): 22.81% showed a response to A1c alone, 3.51% had weight reduction alone, and 12.28% had insulin reduction alone. 8.77% showed A1c and weight response, 26.32% had A1c and insulin response, and 1.75% had weight and insulin response. A complete response was seen in 15.79% of veterans. In conclusion, semaglutide's most common response, in 33.33% of patients, was having a complete response, followed by a reduction in A1c and insulin reduction for 24.82% of patients, and then weight and insulin reduction for 13.48% of patients. Liraglutide's most common response, in 25.19% of patients, was having a complete response, followed by a reduction in A1c and insulin dose for 19.08% of patients, and then reduction in A1c alone for 18.32% of patients. Unlike the others, dulaglutide's most common response was not a complete response, but rather A1c and insulin reduction, for 26.32% patients. Dulaglutide also had 22.81% of patients respond with A1c alone. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.