Side by side

1. 1.Activates GLP-1 receptors on pancreatic beta cells, increasing insulin release in a glucose-dependent way.
2. 2.Reduces glucagon release from alpha cells when glucose is already high.
3. 3.Slows gastric emptying, flattening the rise in glucose after a meal.
4. 4.Acts on hypothalamic appetite centres to reduce hunger and food intake.
5. 5.The antibody-fragment carrier slows clearance, giving a half-life of roughly four to five days.

• Type 2 diabetes (AWARD trial programme)
• Cardiovascular outcomes in type 2 diabetes (REWIND)
• Kidney outcomes in type 2 diabetes as a secondary endpoint
• Weight change as a secondary endpoint
• Fatty liver disease (exploratory imaging substudies)

• HbA1c reductions of roughly 0.7 to 1.6 percentage points depending on dose and comparator
• Modest weight loss, generally 1 to 3 kg in trials
• A 12% relative reduction in major cardiovascular events in REWIND
• Slower gastric emptying and lower post-meal glucose excursions

• Nausea, diarrhoea, vomiting and abdominal discomfort, mostly early in treatment
• Reduced appetite
• Injection-site reactions
• Gallbladder disease
• Pancreatitis (rare)
• Hypoglycaemia when combined with insulin or a sulfonylurea

Research context only - dulaglutide is a prescription medicine and its use is set by a doctor. Licensed dosing starts at 0.75 mg subcutaneously once weekly and may step up to 1.5, 3 or 4.5 mg weekly; trials ran from 26 weeks to over five years. This describes the label and the literature, not a dosing suggestion.

Research context only