Dulaglutide is a long-acting, once-weekly GLP-1 receptor agonist used for Type 2 Diabetes and cardiovascular risk reduction.

Brand: * Trulicity

→ GLP-1 Receptor Agonists Overview

Dulaglutide activates the GLP-1 receptor.

Effects: * Increases glucose-dependent insulin secretion * Decreases glucagon secretion * Slows gastric emptying * Increases satiety * Promotes weight loss

Net effects: * Decreases HbA1c * Reduces body weight * Reduces major adverse cardiovascular events

Low hypoglycemia risk unless combined with insulin or sulfonylureas.

* Glycemic control * Cardiovascular risk reduction in high-risk patients

Dulaglutide reduces: * Myocardial infarction * Stroke * Cardiovascular death

Particularly beneficial in patients with established ASCVD or multiple risk factors.

→ Cardiovascular Modules

REWIND Trial:

* Reduced major adverse cardiovascular events * Included many patients without established ASCVD * Demonstrated broad primary prevention benefit

* Once-weekly subcutaneous injection * No oral formulation * Gradual dose escalation to improve tolerability

Common: * Nausea * Vomiting * Diarrhea * Early satiety

Serious (rare): * Pancreatitis * Gallbladder disease * Theoretical risk of medullary thyroid carcinoma

* Personal or family history of medullary thyroid carcinoma * MEN2 syndrome * Severe GI disease

Use caution in: * History of pancreatitis

Exenatide * Shorter-acting formulations available

Liraglutide * Daily injection * Strong ASCVD data (LEADER)

Semaglutide * Greater weight loss * Oral option available

Dulaglutide: * Once-weekly dosing * Strong primary prevention data * Well tolerated

Dulaglutide: * Strong ASCVD reduction * Modest weight loss * Minimal HF benefit

SGLT2 Inhibitors: * Strong heart failure benefit * Strong renal protection

* Weekly injection * Proven ASCVD benefit * Good primary prevention data * Low hypoglycemia risk * Not primary HF therapy

Related:

→ GLP-1 Receptor Agonists → SGLT2 Inhibitors → Cardiovascular Modules