Metabolic / GLP-1

Dulaglutide

Also: Trulicity

Weekly GLP-1 receptor agonist for type 2 diabetes with proven cardiovascular benefit.

Discussion

Overview

What it is

A GLP-1 analog fused to an antibody fragment so one injection lasts a week. The REWIND trial showed fewer heart attacks, strokes and cardiovascular deaths.

Common forms

Weekly injection pen

Mechanism

How it works

Activates GLP-1 receptors: increases glucose-dependent insulin release, lowers glucagon, slows stomach emptying and reduces appetite.

GLP-1 receptor agonismGlucose-dependent insulin releaseSlower gastric emptying

↓Blood glucose

↓Appetite

Hormonal impact

↑Insulin

↓Glucagon

Evidence

What the research supports

Lowers HbA1c in type 2 diabetesstrong

Reduces major cardiovascular events (REWIND trial)strong

Modest weight lossmoderate

Safety

Side effects & interactions

Side effects

Nausea
Diarrhea
Vomiting
Pancreatitis serious
Gallbladder disease serious
Thyroid C-cell tumor warning (avoid with MEN2 or medullary thyroid cancer history) serious

Medications

Insulin / sulfonylureasmoderateHigher risk of low blood sugar.
Oral drugs needing fast absorptionminorSlowed stomach emptying delays absorption.

Stacking

Combines with

Pairs well

Nothing specific.

Avoid combining

Other GLP-1 drugsDuplicate therapy.

Community

Discussion

Experiences from people who have tried Dulaglutide. Anecdotes are not medical advice.

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