Real‐World Evidence of Long‐Term Dulaglutide Use: Sustained Glycemic and Weight Improvements Beyond Three Years

Objective Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease that requires long‐term glycemic control. The long‐term real‐world evidence for glucagon‐like peptide‐1 receptor agonists remains limited. This study aimed to evaluate the sustained glycemic and weight‐lowering effects of dulaglutide in patients with T2DM who had maintained therapy for at least 3 years. Methods This retrospective cohort study analyzed 403 patients with T2DM who were treated continuously with weekly doses of dulaglutide for ≥ 3 years between 2016 and 2023 at a single tertiary hospital. Baseline and follow‐up data on glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body weight were also assessed. Results The participants had a mean age of 60.0 years, with a mean diabetes duration of 17.4 years. Over a mean follow‐up of 4.3 years, HbA1c decreased from 8.7% (72 mmol/mol) to 7.6% (60 mmol/mol), reflecting a mean reduction of 1.1% (12 mmol/mol) ( p < 0.001), and body weight decreased by 2.9 kg ( p < 0.001). Baseline HbA1c level was the strongest predictor of glycemic improvement. Conclusions Dulaglutide provided durable improvements in glycemic control and weight reduction for more than 3 years, even in patients with long‐standing T2DM and comorbidities. These results support its role as a long‐term treatment option in real‐world clinical practice.