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Dulaglutide

✓ Approved
Dulaglutide (GLP-1 Receptor Agonist)
Also known as: LY2189265, Trulicity
Brand names: Trulicity
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Quick Summary

Dulaglutide (Trulicity) is a once-weekly GLP-1 receptor agonist approved by the FDA for the treatment of type 2 diabetes and for reducing cardiovascular events in adults with T2DM or cardiovascular risk factors. It is an Fc-fusion protein consisting of two modified GLP-1 molecules linked to a modified IgG4 Fc region.

Metabolic & Mitochondrial FDA Approved
Dulaglutide (Trulicity) is a once-weekly GLP-1 receptor agonist approved by the FDA for the treatment of type 2 diabetes and for reducing cardiovascular events in adults with T2DM or cardiovascular risk factors. It is an Fc-fusion protein consisting of two modified GLP-1 molecules linked to a modified IgG4 Fc region. Compared to semaglutide, dulaglutide produces modest weight loss (~3 kg on average) but has a strong cardiovascular outcomes dataset (REWIND trial) and a well-established safety profile.
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Storage Stability
Lyophilized
1–2 years (-20°C)
Reconstituted
~30 days (2–8°C)
Room temp
Avoid

Mechanism of Action

GLP-1 Receptor Agonism

Dulaglutide binds and activates GLP-1 receptors on pancreatic beta cells, stimulating glucose-dependent insulin secretion. This means insulin is only released when glucose is elevated, reducing hypoglycemia risk.

Glucagon Suppression

It suppresses glucagon secretion from alpha cells, reducing hepatic glucose output.

Gastric Emptying & Satiety

Slows gastric emptying, reducing post-meal glucose spikes. Central GLP-1 receptor activation in the hypothalamus reduces appetite, contributing to modest weight loss.

Research Summary

REWIND Trial (Cardiovascular)

The 9,901-patient AWARD/REWIND program showed dulaglutide 1.5 mg weekly reduced the composite MACE endpoint (CV death, non-fatal MI, non-fatal stroke) by 12% vs. placebo in patients with T2DM.

AWARD Studies (Glycemic)

Across the AWARD clinical program, dulaglutide 1.5 mg reduced HbA1c by 1.1–1.6% and body weight by 1.4–3.0 kg depending on the comparator population.

Comparison to Semaglutide

Semaglutide 1 mg weekly outperforms dulaglutide 1.5 mg on HbA1c reduction and weight loss in head-to-head trials (SUSTAIN-7).
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Research Protocols

Starting Dose

0.75 mg once weekly for 4 weeks, then increase to 1.5 mg once weekly. For glycemic control, max approved dose is 4.5 mg weekly.

Injection

Single-dose autoinjector pen (Trulicity device). Subcutaneous into abdomen, thigh, or upper arm. Same day each week.

GI Tolerance

Nausea is most common at initiation. Taking with a light meal and slowly titrating reduces GI burden.

Storage & Handling

Refrigerate at 2–8°C. Do not freeze. Can be kept at room temperature (<30°C) for up to 14 days. Protect from light. Use within 14 days once removed from refrigerator.

References

  • [1]Gerstein HC, et al. "Dulaglutide and cardiovascular outcomes in T2DM (REWIND)." Lancet, 2019.
  • [2]Dungan KM, et al. "Once-weekly dulaglutide versus once-daily liraglutide (AWARD-6)." Lancet, 2014.
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See Also

semaglutideliraglutidetirzepatideretatrutidecagrilintide
Categories: GLP-1MetabolicFDA ApprovedDiabetesObesity
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Data Sources & External References
⬡ PubMed / NCBI, Research Literature ⬡ NCBI, Full-Text Articles ⬡ PubChem, Chemical Database
Source: peer-reviewed literature  ·  Domain: ascendpeptide.org
Dulaglutide
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