Case presentation A 75-year-old overweight male patient visited the outpatient clinic of the Endocrinology Unit for improvement in glycemic control. Medical history He had type 2 diabetes mellitus, hyperuricemia, and hypertension. Medication: Insulin glargine 20 units per day at bedtime, metformin 1 g twice per day, and repaglinide 1 mg before breakfast, lunch, and dinner.
Laboratory analysis HbA1c: 8.3% Glomerular filtration rate (GFR): 50 C-peptide: 2.1 ng/mL Low-density lipoprotein (LDL): 71 mg/dl High post-prandial glucose (above 200 mg/dl) Changes in treatment aiming for glycemic control Cessation of repaglinide Initiation of dulaglutide, a dose of 1.5 mg subcutaneously once a week After one month follow-up The patient reported improvement in glycemic control. The appearance of red macules and papules on his arms and legs had started two weeks after initiating dulaglutide…
