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endocrine:glp1:dulaglutide

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endocrine:glp1:dulaglutide [2026/02/13 00:18] – created andrew2393cnsendocrine:glp1:dulaglutide [2026/02/13 00:19] (current) – andrew2393cns
Line 4: Line 4:
  
 Brand: Brand:
-* Trulicity+  * Trulicity
  
 → [[endocrine:glp1:start|GLP-1 Receptor Agonists Overview]] → [[endocrine:glp1:start|GLP-1 Receptor Agonists Overview]]
- 
--------------------------------------------------------------------- 
  
 ===== Mechanism of Action ===== ===== Mechanism of Action =====
Line 15: Line 13:
  
 Effects: Effects:
-* Increases glucose-dependent insulin secretion 
-* Decreases glucagon secretion 
-* Slows gastric emptying 
-* Increases satiety 
-* Promotes weight loss 
  
-Net effects: +  * Increases glucose-dependent insulin secretion 
-* Decreases HbA1c +  * Decreases glucagon secretion 
-* Reduces body weight +  * Slows gastric emptying 
-* Reduces major adverse cardiovascular events+  * Increases satiety 
 +  * Promotes weight loss
  
-Low hypoglycemia risk unless combined with insulin or sulfonylureas.+Net clinical effects:
  
---------------------------------------------------------------------+  * Decreases HbA1c 
 +  * Reduces body weight 
 +  * Reduces major adverse cardiovascular events 
 + 
 +Low hypoglycemia risk unless combined with insulin or sulfonylureas.
  
 ===== Indications ===== ===== Indications =====
Line 34: Line 32:
 ==== Type 2 Diabetes Mellitus ==== ==== Type 2 Diabetes Mellitus ====
  
-* Glycemic control +  * Glycemic control 
-* Cardiovascular risk reduction in high-risk patients +  * Cardiovascular risk reduction in high-risk patients
- +
---------------------------------------------------------------------+
  
 ==== Atherosclerotic Cardiovascular Disease (ASCVD) ★ ==== ==== Atherosclerotic Cardiovascular Disease (ASCVD) ★ ====
  
 Dulaglutide reduces: Dulaglutide reduces:
-* Myocardial infarction + 
-* Stroke +  * Myocardial infarction 
-* Cardiovascular death+  * Stroke 
 +  * Cardiovascular death
  
 Particularly beneficial in patients with established ASCVD or multiple risk factors. Particularly beneficial in patients with established ASCVD or multiple risk factors.
  
 → [[cardio:intro:start|Cardiovascular Modules]] → [[cardio:intro:start|Cardiovascular Modules]]
- 
--------------------------------------------------------------------- 
  
 ===== Major Trial ===== ===== Major Trial =====
Line 56: Line 51:
 REWIND Trial: REWIND Trial:
  
-* Reduced major adverse cardiovascular events +  * Reduced major adverse cardiovascular events 
-* Included many patients without established ASCVD +  * Included many patients without established ASCVD 
-* Demonstrated broad primary prevention benefit +  * Demonstrated strong primary prevention benefit
- +
---------------------------------------------------------------------+
  
 ===== Dosing ===== ===== Dosing =====
  
-* Once-weekly subcutaneous injection +  * Once-weekly subcutaneous injection 
-* No oral formulation +  * No oral formulation 
-* Gradual dose escalation to improve tolerability +  * Gradual dose escalation improves tolerability
- +
---------------------------------------------------------------------+
  
 ===== Adverse Effects ===== ===== Adverse Effects =====
  
 Common: Common:
-* Nausea + 
-* Vomiting +  * Nausea 
-* Diarrhea +  * Vomiting 
-* Early satiety+  * Diarrhea 
 +  * Early satiety
  
 Serious (rare): Serious (rare):
-* Pancreatitis 
-* Gallbladder disease 
-* Theoretical risk of medullary thyroid carcinoma 
  
---------------------------------------------------------------------+  * Pancreatitis 
 +  * Gallbladder disease 
 +  * Theoretical risk of medullary thyroid carcinoma
  
 ===== Contraindications ===== ===== Contraindications =====
  
-* Personal or family history of medullary thyroid carcinoma +  * Personal or family history of medullary thyroid carcinoma 
-* MEN2 syndrome +  * MEN2 syndrome 
-* Severe GI disease+  * Severe gastrointestinal disease
  
 Use caution in: Use caution in:
-* History of pancreatitis 
  
---------------------------------------------------------------------+  * History of pancreatitis
  
 ===== Dulaglutide vs Other GLP-1 Agents ===== ===== Dulaglutide vs Other GLP-1 Agents =====
  
 [[endocrine:glp1:exenatide|Exenatide]] [[endocrine:glp1:exenatide|Exenatide]]
-* Shorter-acting formulations available+ 
 +  * Shorter-acting formulations available
  
 [[endocrine:glp1:liraglutide|Liraglutide]] [[endocrine:glp1:liraglutide|Liraglutide]]
-* Daily injection + 
-* Strong ASCVD data (LEADER)+  * Daily injection 
 +  * Strong ASCVD data (LEADER trial)
  
 [[endocrine:glp1:semaglutide|Semaglutide]] [[endocrine:glp1:semaglutide|Semaglutide]]
-* Greater weight loss + 
-* Oral option available+  * Greater weight loss 
 +  * Oral option available
  
 Dulaglutide: Dulaglutide:
-* Once-weekly dosing 
-* Strong primary prevention data 
-* Well tolerated 
  
---------------------------------------------------------------------+  * Weekly dosing 
 +  * Strong primary prevention data 
 +  * Well tolerated
  
 ===== GLP-1 vs SGLT2 ===== ===== GLP-1 vs SGLT2 =====
  
 Dulaglutide: Dulaglutide:
-* Strong ASCVD reduction + 
-* Modest weight loss +  * Strong ASCVD reduction 
-* Minimal HF benefit+  * Modest weight loss 
 +  * Minimal heart failure benefit
  
 [[endocrine:sglt2:start|SGLT2 Inhibitors]]: [[endocrine:sglt2:start|SGLT2 Inhibitors]]:
-* Strong heart failure benefit 
-* Strong renal protection 
  
---------------------------------------------------------------------+  * Strong heart failure benefit 
 +  * Strong renal protection
  
 ===== Clinical Pearls ===== ===== Clinical Pearls =====
  
-* Weekly injection +  * Weekly injection 
-* Proven ASCVD benefit +  * Proven ASCVD benefit 
-* Good primary prevention data +  * Good primary prevention data 
-* Low hypoglycemia risk +  * Low hypoglycemia risk 
-* Not primary HF therapy+  * Not primary heart failure therapy
  
---------------------------------------------------------------------+===== Related =====
  
-Related: +  * [[endocrine:glp1:start|GLP-1 Receptor Agonists]] 
- +  * [[endocrine:sglt2:start|SGLT2 Inhibitors]] 
-→ [[endocrine:glp1:start|GLP-1 Receptor Agonists]] +  * [[cardio:intro:start|Cardiovascular Modules]]
-→ [[endocrine:sglt2:start|SGLT2 Inhibitors]] +
-→ [[cardio:intro:start|Cardiovascular Modules]]+
endocrine/glp1/dulaglutide.1770941881.txt.gz · Last modified: by andrew2393cns