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 clinical 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 strong primary prevention benefit

* Once-weekly subcutaneous injection * No oral formulation * Gradual dose escalation improves 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 gastrointestinal disease

Use caution in:

* History of pancreatitis

Exenatide

* Shorter-acting formulations available

Liraglutide

* Daily injection * Strong ASCVD data (LEADER trial)

Semaglutide

* Greater weight loss * Oral option available

Dulaglutide:

* Weekly dosing * Strong primary prevention data * Well tolerated

Dulaglutide:

* Strong ASCVD reduction * Modest weight loss * Minimal heart failure benefit

SGLT2 Inhibitors:

* Strong heart failure benefit * Strong renal protection

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

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