dulaglutide

Dulaglutide is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist used to improve glycemic control in adults with type 2 diabetes. It is marketed under the brand name Trulicity and is administered by subcutaneous injection once weekly.

Dulaglutide is a recombinant fusion protein that activates GLP-1 receptors, leading to glucose-dependent enhancement of insulin secretion, suppression of glucagon, slower gastric emptying, and increased satiety. These actions collectively help lower postprandial and fasting blood glucose and can contribute to modest weight loss.

Indications include improving glycemic control in adults with type 2 diabetes as an adjunct to diet and exercise, often in combination with other antidiabetic agents when metformin alone is insufficient or not tolerated. It is not indicated for type 1 diabetes or for the treatment of diabetic ketoacidosis. Use in pediatric patients is determined by local guidelines and approvals.

Dulaglutide is given as a once-weekly subcutaneous injection in the abdomen, thigh, or upper arm. Starting doses are typically 0.75 mg weekly, with potential escalation to higher doses based on response and tolerability, in accordance with regional labeling.

Common adverse effects include nausea, vomiting, diarrhea, decreased appetite, and injection-site reactions. Serious risks include pancreatitis, cholelithiasis, and rare thyroid C-cell tumors; there is a contraindication for individuals with personal or family history of medullary thyroid carcinoma or MEN2. Hypoglycemia risk increases when used with insulin or sulfonylureas, requiring adjustments to co-administered therapies.

Pharmacologically, dulaglutide is a long-acting peptide designed for weekly dosing, with no routine hepatic metabolism considerations. Regulatory approvals exist in various regions for adults with type 2 diabetes, marketed as Trulicity.

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