Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in the management of type 2 diabetes mellitus (T2DM) and obesity because of their glucoselowering and weight reduction benefits. However, realworld outcomes may differ from clinical trial data. Methodology: This retrospective cohort study included adults with T2DM and obesity initiated on oral semaglutide or injectable dulaglutide at Hospital Sultan Haji Ahmad Shah between 2023 and 2025. Baseline and approximately 6-month follow-up data were obtained from electronic medical records. Outcomes included weight, body mass index (BMI), glycated hemoglobin A1c (HbA1c), total daily insulin dose (TDD), low-density lipoprotein (LDL), and gastrointestinal adverse effects. Results are presented as median (interquartile range, IQR). Results: A total of 22 patients were included, with a median age of 45 years (IQR 39.3–54.5); 13 (59.1%) were male. Thirteen patients (59.1%) received oral semaglutide and nine (40.9%) received injectable dulaglutide. In the semaglutide group, median HbA1c changed from 8.1% (7.4–9.1) to 8.2% (7.1– 9.3), weight from 95.4 kg (84.0–99.1) to 89.6 kg (79.0–100.0), BMI from 33.9 kg/m² (31.4–40.8) to 33.6 kg/m² (31.2–35.6), TDD from 64 IU/day (20–82) to 46 IU/day (18–48), and LDL from 2.2 mmol/L (1.6–2.3) to 2.3 mmol/L (1.3–3.0). In the dulaglutide group, median HbA1c improved from 7.6% (7.4–9.6) to 6.9% (6.5–8.4), weight from 117.0 kg (101.0–121.0) to 111.0 kg (105.0–119.0), BMI from 41.0 kg/ m² (40.0–49.0) to 42.5 kg/m² (38.0–48.0), TDD from 33 IU/ day (30.5–34.0) to 34 IU/day (30.5–34.0), and LDL from 2.2 mmol/L (1.8–2.9) to 2.6 mmol/L (2.0–4.0). Gastrointestinal side effects occurred in 4/13 (30.8%) oral semaglutide users and 0/9 dulaglutide users. Conclusion Injectable dulaglutide showed greater improvement in HbA1c, while both groups demonstrated variable effects on weight, BMI, insulin requirement, and LDL in routine practice.
Adult ; dulaglutide ; semaglutide ; Diabetes Mellitus, Type 2 ; Obesity