Key Takeaways

  • Dulaglutide significantly reduces HbA1c levels in adults with Type 2 Diabetes Mellitus (T2DM). In the AWARD-5 study, patients treated with 1.5 mg of dulaglutide experienced a mean reduction in HbA1c of 1.6% from baseline over 24 weeks, compared to a 0.9% reduction with sitagliptin, showcasing its efficacy in improving glycemic control.
  • The average cost of dulaglutide, sold under the brand name Trulicity, can cost patients up to $977.42 per month. This cost can vary based on insurance coverage, highlighting the importance of consulting with healthcare providers or insurance companies to understand potential out-of-pocket expenses.
  • As demonstrated in the REWIND study, dulaglutide has been indicated to reduce the risk of major adverse cardiovascular events (MACE) by 12% compared to placebo over a median follow-up of 5.4 years. This makes it a valuable option for patients with T2DM at high risk of heart attacks, strokes, or cardiovascular-related death.
  • Clinical trials report weight loss as a secondary effect of dulaglutide. In the Awards-DT2 study, patients experienced a mean weight reduction of approximately 2.9 kg (about 6.4 pounds), depending on the dose. This is attributed to the medication’s effects on decreasing gastric emptying and increasing satiety.
  • Dulaglutide is administered once a week via subcutaneous injection, offering flexibility and convenience to patients. The starting dose is typically 0.75 mg, possibly increasing to a maximum of 4.5 mg once weekly based on glycemic response and tolerability.
  • In clinical trials involving 6005 patients with T2DM, dulaglutide did not significantly impact kidney function. It showed stable eGFR values and a minor decrease in albuminuria without an increased risk of acute renal failure. The incidence of adverse events related to potential acute renal failure was low, at only 3.4 events per 1000 patient-years.

Diabetes is a chronic medical condition that affects a significant portion of the population, with 38 million Americans being diagnosed with it. Type 2 diabetes is the most common form of the disease, accounting for 90-95% of all cases. This type of diabetes typically affects people over the age of 45, but it is becoming increasingly common among younger people, including children, teenagers, and young adults.

Living with type 2 diabetes can be challenging. It requires constant monitoring of blood sugar levels, diet adjustments, and regular exercise. Despite these efforts, managing diabetes effectively often requires medical intervention. However, with so many drugs available, it’s hard to distinguish which is best suited for your specific needs, especially when considering the potential side effects and associated warnings.

In this article, you will learn about dulaglutide, another effective medication for treating type 2 diabetes. We’ll cover what dulaglutide is, how it controls blood sugar levels, its uses, possible side effects, and important warnings. So, if you or someone you know is suffering from type 2 diabetes, keep reading to learn more about this medication and how it can help manage the condition.

What Is A Dulaglutide?

Trulicity Pens

Dulaglutide, or Trulicity, is a medication for treating type 2 diabetes mellitus in adults. It was approved by the FDA in 2014 and belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class of drugs. Dulaglutide helps enhance the body’s ability to control blood glucose levels, making it an important tool for diabetes management.

One of the benefits of dulaglutide is that it can be administered once a week via subcutaneous injection, providing patients with a convenient and effective option for controlling their blood sugar levels. This is particularly helpful for those who are looking for an alternative to daily insulin injections or need additional therapy to oral diabetes medications to achieve better glycemic control.

How Dulaglutide Works

Dulaglutide mimics the incretin hormone glucagon-like peptide-1 (GLP-1), which plays a crucial role in glucose regulation. Dulaglutide activates the GLP-1 receptor on the pancreatic beta cells’ surface, increasing intracellular cAMP levels. This, in turn, promotes insulin release in a glucose-dependent manner, which helps lower blood glucose levels back to normal. Besides, dulaglutide decreases glucagon secretion from pancreatic alpha cells, which reduces blood glucose levels. Additionally, dulaglutide slows down the rate of gastric emptying, which contributes to a feeling of fullness, aiding in weight management.

Moreover, dulaglutide’s glucose-dependent action reduces the risk of hypoglycemia, which is a common concern with some diabetes medications. This medication produces several beneficial effects that help manage blood sugar levels in adults with type 2 diabetes mellitus. It is crucial to note that dulaglutide should not be used to treat type 1 diabetes or diabetic ketoacidosis. Before taking dulaglutide, it is important to consult with a healthcare professional to determine if it is the right medication for you.

Indications and Usage

Candidates for dulaglutide typically include adults with type 2 diabetes who have not been able to achieve or maintain adequate glycemic control through diet and exercise alone or in combination with other diabetic medications.

Here are the indications and usage of dulaglutide:

Use for Improving Glycemic Control in Adults with Type 2 Diabetes Mellitus

Dulaglutide has been extensively studied for its efficacy in improving glycemic control in adults with type 2 diabetes mellitus (T2DM). In fact, six separate studies, known as AWARD-1 to AWARD-6, have been conducted to evaluate its effectiveness. These studies have investigated the effects of dulaglutide both as a monotherapy and in combination with other antidiabetic medications, such as metformin, sulfonylureas, thiazolidinediones, and insulin.

The results of these studies have consistently shown that dulaglutide significantly reduces HbA1c levels compared to placebo or other active comparators. For example, in the AWARD-5 study, patients treated with 1.5 mg of dulaglutide experienced a mean reduction in HbA1c of 1.6% from baseline, compared to 0.9% with sitagliptin over 24 weeks. This demonstrates the efficacy of dulaglutide in improving glycemic control in patients with T2DM, particularly when combined with other antidiabetic medications.

Use to Reduce the Risk of Major Cardiovascular Events

In addition to its role in managing blood sugar levels, dulaglutide has been indicated to reduce the risk of major adverse cardiovascular events (MACE) in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors. This cardiovascular benefit makes dulaglutide a particularly valuable option for diabetic patients at high risk of heart attacks, strokes, or cardiovascular-related death.

Clinical trials, such as the REWIND study, have evaluated the efficacy of dulaglutide in reducing the risk of MACE. The REWIND study was a large, multicenter, randomized, placebo-controlled trial with 9,901 participants. It was found that 1.5 mg of dulaglutide once weekly significantly reduced the risk of MACE by 12% compared to placebo over a median follow-up of 5.4 years.

Dosage and Administration

Injecting Dulaglutide into Stomach

A subcutaneous injection of 0.75 mg of dulaglutide once a week is recommended to start the treatment. However, the dosage can be adjusted based on the patient’s response to the medication. For patients who need additional glycemic control, the dose can be increased to 1.5 mg once weekly after assessing the tolerability and effectiveness of the 0.75 mg dose. If further glycemic control is required, the dose can be increased to 3 mg once weekly, following at least 4 weeks on the 1.5 mg dose.

It is important to note that the maximum recommended dosage of Trulicity is 4.5 mg once weekly. Based on the patient’s glycemic response and tolerability, this maximum dosage can only be reached after at least 4 weeks on the 3 mg dose. It is crucial to follow these dosage guidelines to ensure the most effective treatment while minimizing any potential side effects.

Administration Instructions

Dulaglutide is administered once weekly, at any time of the day, with or without food. To avoid skin issues, such as irritation or lipodystrophy, it is essential to rotate the injection site with each dose, and the same area of the body should not be used consecutively. The injection can be given subcutaneously into the abdomen, thigh, or upper arm.

Before using dulaglutide, visually inspect the pen for particulate matter or discoloration. The solution should appear clear and colorless. Do not use the medication if it looks cloudy, discolored, or contains particles. Trulicity should not be mixed with any other insulin or solution.

If a dose is missed and the next scheduled dose is not due for at least three days (72 hours), administer the missed dose as soon as possible and follow the regular once-weekly dosing schedule. However, if the next scheduled dose is due within one or two days, skip the missed dose and resume with the next regular dose.

If necessary, the day of weekly administration can be changed, provided the last dose was taken three or more days before.

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Warnings, Precautions, and Contraindications

During animal testing, dulaglutide was observed to induce thyroid C-cell tumors. While the direct relevance of these findings to human patients remains undetermined, there is an absence of conclusive evidence proving that dulaglutide induces thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans.

Given these uncertainties, Dulaglutide is strictly contraindicated for individuals with either a personal or familial history of MTC and for those diagnosed with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Patients should be thoroughly informed about the potential risk of developing MTC and encouraged to remain vigilant for symptoms indicative of thyroid tumors.

Certain conditions and medical histories necessitate avoiding dulaglutide due to increased risk factors. These contraindications include:

  • A personal or family history of medullary thyroid carcinoma (MTC).
  • Diagnosis of Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2).
  • A prior serious hypersensitivity reaction to dulaglutide or any of its components indicates a risk of allergic reaction upon re-exposure.

Other Significant Warnings and Precautions

Woman having abdominal pain

Beyond the primary concerns that might contraindicate medication use, additional warnings and precautions must be considered to ensure patient safety and treatment efficacy. Like many advanced medications, dulaglutide can cause a range of potential risks and side effects, which can vary from mild to severe. These warnings include conditions such as:

Pancreatitis: Pancreatitis has been reported in clinical trials with dulaglutide. In studies evaluating Trulicity 1.5 mg, 3 mg, or 4.5 mg once weekly, pancreatitis occurred in 0.2% (1 patient), 0.3% (2 patients), and 0.5% (3 patients) of participants, respectively. Patients should discontinue Trulicity if pancreatitis is suspected, and it should not be restarted if pancreatitis is confirmed.

Hypersensitivity Reactions: Serious hypersensitivity reactions, including anaphylactic reactions and angioedema, have been reported postmarketing. Patients should discontinue dulaglutide and seek medical advice promptly if such reactions occur.

Severe Gastrointestinal Disease: Dulaglutide may be associated with gastrointestinal adverse reactions, sometimes severe. Symptoms include nausea, vomiting, diarrhea, abdominal pain, and decreased appetite. It is important to note that this medication has not been studied in patients with severe gastrointestinal disease, including severe gastroparesis, and therefore it is not recommended for these patients.

Diabetic Retinopathy Complications in Patients: In a cardiovascular outcomes trial, diabetic retinopathy complications occurred in 1.9% of patients treated with dulaglutide 1.5 mg versus 1.5% of placebo-treated patients. The proportion of patients with diabetic retinopathy complications was higher among those with a history of diabetic retinopathy at baseline. Patients with a history of diabetic retinopathy should be monitored for progression of this condition.

Considerations

Several important factors should be considered before using dulaglutide. Below are some key considerations.

Pregnancy: If you are pregnant, it is important to note that limited data are available on the use of dulaglutide during pregnancy. Animal studies have shown that high doses of dulaglutide may have adverse reproductive effects. Therefore, dulaglutide should only be used during pregnancy if the potential benefit to the mother justifies the potential risk to the fetus.

Lactation: If you are breastfeeding, consider that no information is available on the presence of dulaglutide in human milk. Additionally, the effects of dulaglutide on the breastfed infant and milk production are unknown. It is important to weigh the benefits of breastfeeding against the mother’s clinical need for dulaglutide.

Pediatric Use: The safety and effectiveness of dulaglutide in pediatric patients have not been established, and its use in individuals under 18 years of age is not recommended. If you are under 18, discussing alternative treatment options with your healthcare provider is important.

Geriatric Use: While no overall differences in safety or effectiveness were observed between elderly and younger patients, it is still important to exercise caution when treating the elderly with dulaglutide. Some older individuals may have greater sensitivity, which cannot be ruled out. If you are an elderly patient, discussing your health needs with your healthcare provider is important.

Does Dulaglutide Cause Weight Loss?

Woman looking in mirror measuring waist line

Dulaglutide functions as a glucagon-like peptide-1 (GLP-1) receptor agonist, which not only helps improve glycemic control but also affects body weight. GLP-1 receptor agonists like dulaglutide have been associated with weight loss in clinical trials and patient reports. However, it’s important to note that Trulicity is not approved as a weight loss medication. Weight loss is considered a secondary effect of the medication.

Clinical studies have shown that dulaglutide can help reduce body weight. In the Awards-DT2 study, patients treated with dulaglutide experienced a mean weight reduction of about 2.9 kg (approximately 6.4 pounds), depending on the dose. The REWIND trial, which focused on cardiovascular outcomes, also provided data on weight loss among participants. Dulaglutide showed a modest reduction in body weight compared to placebo, with participants experiencing an average weight loss of about 1.9 kg (approximately 4.2 pounds) for the study.

The weight loss observed with dulaglutide is believed to result from its effects on decreasing gastric emptying and increasing satiety. This means that patients may feel fuller longer, leading to reduced calorie intake and, consequently, weight loss.

Related Articles:

Buy Canadian Insulin is dedicated to providing resources and information to help you maintain good health. If you want to learn more about comparing dulaglutide to other diabetes medications, you can read some of our articles.

Wrap-Up

In conclusion, dulaglutide is an effective medication for managing type 2 diabetes mellitus in adults. It works by mimicking the actions of the incretin hormone GLP-1, which plays a crucial role in glucose regulation. Dulaglutide helps to control blood glucose levels, reduce the risk of hypoglycemia, decrease glucagon secretion, slow down the rate of gastric emptying, and promote weight loss.

It is a convenient and effective option for those who are looking for an alternative to daily insulin injections or need additional therapy to oral diabetes medications to achieve better glycemic control. However, like all medications, it has possible side effects and important warnings, and it is essential to consult a doctor before taking it.

FAQs On Dulaglutide

Is dulaglutide a type of insulin?

No, dulaglutide is not a form of insulin. It is a GLP-1 receptor agonist, which means it mimics the incretin hormones the body usually produces to stimulate insulin release in response to food intake. It helps the pancreas to release insulin when blood glucose levels are high but does not replace insulin.

Is dulaglutide the same as Ozempic?

No, Dulaglutide (Trulicity) and Ozempic (semaglutide) are not the same. While both are GLP-1 receptor agonists used to treat type 2 diabetes, they have different active ingredients plus minor differences in efficacy and cardiovascular benefit.

Is dulaglutide considered a safe medication?

Dulaglutide is approved for use and can be safe according to a healthcare provider’s instructions. However, it may carry risks for certain individuals, including the potential for thyroid tumors. Patients should discuss the benefits and risks with their healthcare provider.

Is dulaglutide more effective than insulin in treating diabetes?

Dulaglutide and insulin serve different purposes and work in different ways. Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist that is not cleared by the kidneys and confers a lower risk of hypoglycemia than insulin.

Can dulaglutide cause kidney failure?

In clinical trials involving 6005 patients with Type 2 Diabetes, dulaglutide did not significantly impact kidney function. The study showed stable eGFR values and a minor decrease in albuminuria without an increased risk of acute renal failure. The incidence of adverse events related to potential acute renal failure was low across all treatment groups, with only 3.4 events per 1000 patient-years for dulaglutide. These findings highlight the safety of dulaglutide in terms of kidney health.

What is the average cost of dulaglutide medication?

The average cost of dulaglutide medication, also known as Trulicity, is $977.42 per month. However, the actual amount you pay may vary depending on your insurance plan. It’s recommended that you consult with your healthcare provider or insurance company to find out if they cover any of the costs associated with this medication.

How long does it take for dulaglutide to start working?

Dulaglutide may take up to 5 weeks to lower blood glucose levels, with the maximum effect not seen for 3-6 months. Individual responses can vary.

Sources

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Eli Lilly and Company. (2019, June 9). Trulicity® (dulaglutide) significantly reduced major cardiovascular events for broad range of people with type 2 diabetes. Retrieved from https://investor.lilly.com/news-releases/news-release-details/trulicityr-dulaglutide-significantly-reduced-major

A-S Medication Solutions. (n.d.). TRULICITY- dulaglutide injection, solution. DailyMed. Retrieved, from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm

Texas Health and Human Services. (n.d.). Dulaglutide (Trulicity®) [PDF]. Retrieved from https://www.hhs.texas.gov/sites/default/files/documents/dulaglutide-trulicity-monograph.pdf

Alghamdi, A., Alsaeddi, A., Malki, H., & Alsaedi, A. (2023, September 4). A Case Report of a Pregnant Woman With Type 2 Diabetes Mellitus Using Dulaglutide During the First Trimester of Pregnancy. Cureus, 15(9), e44644.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552061/

Center for Drug Evaluation and Research. (2020). TRULICITY® (dulaglutide) injection, for subcutaneous use: Medication guide. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/125469s036lbl.pdf

Tuttle, K. R., McKinney, T. D., Davidson, J. A., Anglin, G., Harper, K. D., & Botros, F. T. (2017). Effects of once?weekly dulaglutide on kidney function in patients with type 2 diabetes in phase II and III clinical trials. Diabetes, Obesity & Metabolism, 19(3), 436–441. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347883/