Dulaglutide vs insulin in adolescents with thalassaemia-induced diabetes: effect on metabolism and atherogenesis (DIADEMA)
Authors' conclusion
The glucagon-like peptide-1 receptor agonist dulaglutide therapy was associated with greater improvements in glycaemic control and variability compared with insulin among adolescents with TDT-induced diabetes, without risk of hypoglycaemia or compromising safety.
Study context
- Population
- Adolescents aged 10–18 years with TDT-induced diabetes uncontrolled on metformin; Ain Shams University, Cairo, Egypt
- Participants
- 80 adolescents
- Comparison
- Dulaglutide vs conventional basal-bolus insulin
- Primary endpoint
- Change in CV as an index of glycaemic variability
- Follow-up
- Baseline to week 24
Methodological detailsopen-label, parallel-group, outcome assessors masked
- Open-label
- Parallel-group
- Outcome assessors masked
Primary result
As reported in the abstract
CV (glycaemic variability), change from baseline · 24 weeks
Dulaglutide
35.05
± 4.30 · %
Insulin
43.26
± 5.75 · %
- Dulaglutide: significant decrease in CV from 39.45 ± 3.97% to 35.05 ± 4.30%
- P < 0.001
- Insulin: CV significantly increased from 39.85 ± 4.99% to 43.26 ± 5.75%
- P < 0.001
- Estimated standardised effect size for the between-group difference in CV
- 1.69 (95% CI 1.16, 2.22)
Further findings
Other glycaemic, pancreatic, iron and lipid measures · 24 weeks
- Dulaglutide significantly decreased time above range, fasting blood glucose, HbA1c, fructosamine, total cholesterol and serum ferritin, and increased fasting C-peptide and TIR vs baseline and vs insulin
- P < 0.05
- Insulin: GMI decreased vs baseline, but time above range significantly increased
- P < 0.001
Safety
- No serious adverse event was reported
Original publication
Dulaglutide vs insulin in adolescents with thalassaemia-induced diabetes: effect on metabolism and atherogenesis (DIADEMA). Diabetologia. Published 19 August 2026. doi:10.
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