GLP-1 & incretin
Dulaglutide
A once-weekly GLP-1 receptor agonist approved for type 2 diabetes, with proven cardiovascular benefit in people at high risk.
What it is
Dulaglutide is a long-acting GLP-1 receptor agonist engineered as a fusion protein: two copies of a GLP-1 analogue joined to an antibody fragment that keeps it circulating for days. That construction is why it is injected once a week. It is a prescription medicine (Trulicity) licensed for type 2 diabetes, and its evidence base includes a large cardiovascular outcome trial.
How it works
- 1
Activates GLP-1 receptors on pancreatic beta cells, increasing insulin release in a glucose-dependent way.
- 2
Reduces glucagon release from alpha cells when glucose is already high.
- 3
Slows gastric emptying, flattening the rise in glucose after a meal.
- 4
Acts on hypothalamic appetite centres to reduce hunger and food intake.
- 5
The antibody-fragment carrier slows clearance, giving a half-life of roughly four to five days.
What it's studied for
Reported and studied effects
- 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
Research protocol notes
Research context onlyResearch 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.
These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.
Possible side effects and contraindications
Safety profile
Possible side effects
- 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
Contraindications and cautions
- Personal or family history of medullary thyroid carcinoma
- Multiple endocrine neoplasia syndrome type 2
- Pregnancy
- Prior serious hypersensitivity to the drug
- Severe gastroparesis needs specialist assessment
A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.
Evidence assessment
The AWARD randomised programme plus the REWIND cardiovascular outcome trial (nearly 10,000 participants), with regulatory approval in the EU and US.
References
- 01Gerstein et al., Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND), Lancet 2019
- 02European Medicines Agency - Trulicity product information
References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.
Related
Related peptides
Other entries in GLP-1 & incretin.
GLP-1 & incretin
Cagrilintide
A long-acting amylin analogue that slows digestion and reduces appetite, studied alone and combined with semaglutide for obesity.
GLP-1 & incretin
Exenatide
A GLP-1 receptor agonist derived from Gila monster saliva, approved for type 2 diabetes in twice-daily and once-weekly forms.
GLP-1 & incretin
Liraglutide
A once-daily GLP-1 receptor agonist approved for type 2 diabetes and weight management, and the first in its class shown to reduce cardiovascular events.