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Study breakdown

Dulaglutide (Trulicity): Evidence Review of a Once-Weekly GLP-1 Drug for Type 2 Diabetes

evidence
The takeaway

Dulaglutide, a once-weekly GLP-1 receptor agonist, effectively lowers blood sugar, promotes weight loss, and improves cardiovascular markers in type 2 diabetes with similar efficacy and safety to other drugs in its class.

Once-weekly dosing

Dulaglutide offers the convenience of a single weekly injection while delivering consistent blood sugar control, weight loss, and cardiovascular risk factor improvements

What the researchers found

Dulaglutide demonstrated efficacy across multiple clinical scenarios: as first-line, second-line, and third-line therapy for type 2 diabetes. Key benefits included reductions in HbA1c, fasting plasma glucose, and postprandial glucose levels, along with weight loss.

Additional benefits included improved β-cell function and cardiovascular risk factor improvements (lower blood pressure, improved lipid levels). The drug had a low hypoglycemia risk and an adverse effect profile similar to other GLP-1 RAs, primarily transient gastrointestinal symptoms with a potential risk for pancreatitis.

Why it matters

The GLP-1 receptor agonist class has become one of the most important treatment options for type 2 diabetes. Dulaglutide's once-weekly dosing offers a practical advantage for patients who prefer less frequent injections, potentially improving adherence to treatment and long-term diabetes management.

How the study worked

Evidence-based narrative review examining clinical trial data on dulaglutide's efficacy and safety in type 2 diabetes. The review covers data from the AWARD (Assessment of Weekly Administration of LY2189265 in Diabetes) clinical trial program and other available evidence at the time of publication.

What this study cannot tell us

This review was published in 2015, relatively early in dulaglutide's clinical use. Long-term safety and efficacy data, including the REWIND cardiovascular outcomes trial results, were not yet available. The review does not compare dulaglutide to newer agents like semaglutide or tirzepatide. Head-to-head comparisons with all other GLP-1 RAs were limited.

How to read the evidence

This is an evidence-based narrative review summarizing data from multiple randomized controlled trials in the AWARD clinical trial program. While it provides a comprehensive overview of the available evidence, it is a review rather than a primary research study or meta-analysis.

When this study was published

Published in 2015, this was an early comprehensive review of dulaglutide. Since then, substantial additional evidence has emerged, including the REWIND cardiovascular outcomes trial showing cardiovascular benefits in a broad type 2 diabetes population.

The bigger picture

Dulaglutide was one of the earlier once-weekly GLP-1 receptor agonists, helping establish the convenience paradigm that has since been extended by semaglutide and tirzepatide. While newer agents have shown greater weight loss and cardiovascular benefits, dulaglutide (and its REWIND cardiovascular outcome trial) contributed important evidence that GLP-1 drugs provide cardiovascular protection in type 2 diabetes.

Questions still open

  • How does dulaglutide's cardiovascular protection compare to semaglutide and tirzepatide based on subsequent trial data?
  • Is dulaglutide's once-weekly dosing convenience sufficient to compete with oral semaglutide for patient preference?
  • What role does dulaglutide play in current treatment guidelines given the availability of newer GLP-1-based therapies?

Common questions

How does dulaglutide compare to other GLP-1 drugs?
At the time of this review, dulaglutide showed similar efficacy and safety to other GLP-1 receptor agonists. Its main advantage is once-weekly dosing with a user-friendly pen device. Since 2015, newer agents like semaglutide and tirzepatide have shown greater weight loss and additional cardiovascular benefits, but dulaglutide remains an effective and well-tolerated option with its own cardiovascular outcome data (REWIND trial).
What are the main side effects of dulaglutide?
The most common side effects are gastrointestinal: nausea, vomiting, diarrhea, and decreased appetite, which are typically temporary and most pronounced when starting treatment or increasing the dose. The risk of dangerous low blood sugar (hypoglycemia) is low when used without insulin or sulfonylureas. There is a potential risk for pancreatitis, though this is rare.

Read the original research

Dulaglutide: an evidence-based review of its potential in the treatment of type 2 diabetes.

Core evidence, 10, 11-21

Citation

Edwards, Krystal L; Minze, Molly G. (2015). Dulaglutide: an evidence-based review of its potential in the treatment of type 2 diabetes.. Core evidence, 10, 11-21. https://doi.org/10.2147/CE.S55944