Dulaglutide – Mechanism, Dosage & Side Effects
Dulaglutide is a prescription medication used to treat type 2 diabetes and reduce cardiovascular risk. It belongs to the class of GLP-1 receptor agonists and is injected once weekly.
Wissenswertes über "Dulaglutide"
Dulaglutide is a prescription medication used to treat type 2 diabetes and reduce cardiovascular risk. It belongs to the class of GLP-1 receptor agonists and is injected once weekly.
What is Dulaglutide?
Dulaglutide is a prescription medication approved for the treatment of type 2 diabetes mellitus in adults. It belongs to the drug class of GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists) and is administered as a once-weekly subcutaneous injection. It is marketed under the brand name Trulicity®.
Indication
Dulaglutide is approved for:
- Treatment of type 2 diabetes mellitus as an add-on to other antidiabetic medications or as monotherapy when metformin is not tolerated
- Reduction of the risk of major adverse cardiovascular events (e.g., heart attack, stroke) in adults with type 2 diabetes who have established cardiovascular disease or are at high cardiovascular risk
Mechanism of Action
Dulaglutide mimics the action of the naturally occurring hormone GLP-1 (glucagon-like peptide-1), which is released from the intestine after meals. It acts through several pathways:
- Insulin secretion: Dulaglutide stimulates the pancreas to release insulin, but only in the presence of elevated blood glucose levels (glucose-dependent mechanism).
- Glucagon suppression: It inhibits the release of glucagon, a hormone that raises blood sugar levels.
- Gastric emptying: It slows gastric emptying, leading to prolonged feelings of fullness after meals.
- Central nervous system: It acts on appetite-regulating centers in the brain, reducing overall food intake.
Because its insulin-stimulating effect is glucose-dependent, the risk of hypoglycemia (low blood sugar) when used alone is low.
Dosage and Administration
Dulaglutide is injected subcutaneously (under the skin) once a week, regardless of meal times. The recommended starting dose is 0.75 mg per week. The dose can be increased to 1.5 mg per week if additional glycemic control is needed. Higher doses (3 mg and 4.5 mg) are approved in some regions. The injection is administered in the abdomen, thigh, or upper arm using a prefilled, single-use auto-injector pen.
Side Effects
The most common side effects involve the gastrointestinal tract, particularly at the start of treatment:
- Nausea
- Diarrhea
- Vomiting
- Abdominal pain
- Decreased appetite
These symptoms are typically temporary and tend to subside within a few weeks. Less common but more serious adverse effects may include:
- Pancreatitis (inflammation of the pancreas)
- Increased heart rate
- Injection site reactions
- Animal studies have shown an increased risk of thyroid tumors – the clinical relevance in humans remains unclear.
Contraindications
Dulaglutide should not be used in patients with:
- Type 1 diabetes mellitus
- Diabetic ketoacidosis
- Known hypersensitivity to dulaglutide
- Severe renal impairment (use with caution)
- Personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN-2)
Treatment Context
Dulaglutide can be used as monotherapy or in combination with metformin, sulfonylureas, SGLT-2 inhibitors, or insulin. The landmark REWIND trial demonstrated that dulaglutide significantly reduces the risk of major adverse cardiovascular events in patients with type 2 diabetes. In addition, treatment with dulaglutide is associated with moderate body weight reduction, which may be beneficial for overweight patients with type 2 diabetes.
References
- European Medicines Agency (EMA): Trulicity (dulaglutide) – Summary of Product Characteristics (SmPC), 2023.
- Gerstein HC et al. - Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. The Lancet, 2019; 394(10193): 121–130.
- American Diabetes Association (ADA): Standards of Medical Care in Diabetes – 2024. Diabetes Care, 2024; 47(Suppl 1).
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Related search terms: Dulaglutide + Dulaglutid