Type 2 diabetes mellitus has a major impact on costs for healthcare and society. The expected rise in the prevalence of diabetes over the coming decades may create problems for the sustainability of healthcare systems. The rise in direct costs is the main issue in diabetes, especially the treatment of acute and chronic complications that often need hospital care. Severe hypoglycemia (SH) is the most frequent acute complication and constitutes a remarkable economic burden for national healthcare systems.
Incretin mimetics (GLP-1 analogues) and enhancers [dipeptidyl peptidase-4 (DPP-4) inhibitors] are two new classes of therapeutic agents for the treatment of type 2 diabetes. They are innovative drugs because of their new mechanism of action: the potentiation of incretin hormones signalling (e.g. GLP-1) that hold the promise of overcoming the major limitations of traditional treatments, including the increased risk for hypoglycemia and weight gain.
Furthermore, patients treated with dulaglutide had significantly higher adherence, were more persistent, and had lower discontinuation rates compared with patients treated with other incretins and gliptins. This is an important evidence, considering that patient satisfaction is a widely used health care quality metric. 

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Key words: type 2 diabetes mellitus, costs for healthcare system, GLP-1 analogues, DPP-4 inhibitors, dulaglutide