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What is Trulicity (Dulaglutide)?

Trulicity is the brand name for a molecule used in the treatment of type 2 diabetes. The generic name is Dulaglutide. It is a relatively new product and is a type of injectable therapy, but it is not insulin. It comes in the form of a disposable single use pen in either 0.75mg dose and 1.5mg dose, making it relatively safe and easy to administer.


Dulaglutide (Trulicity) is the synthetic version of a naturally occurring human hormone, called Glucagon-like peptide 1 or GLP-1 that is administered once weekly.

Whether you have diabetes, or you don’t have diabetes, we all make GLP-1. It has become clear that GLP-1 is a really important hormone to help us regulate our blood sugar levels.



How does GLP-1 work and what is the mechanism of action?

After we eat, GLP-1 is released from the small intestine.


GLP-1 has a number of actions in the body that improve blood sugar levels that include the for 1 last update 26 May 2020 following: GLP-1 has a number of actions in the body that improve blood sugar levels that include the following:

  • Lowers blood glucose levels by stimulating the release of insulin from the pancreas. This process magnifies the release of insulin and is dependent on the blood sugar level. It is does occur if the blood glucose level is low and so GLP-1 medications do not tend to cause hypoglycaemia or low blood sugar levels.
  • Reduces the amount of glucose that your liver is producing. Typically, the liver produces glucose, and it does this when you are in periods of starvation. So, the liver is a storage mechanism that can release sugar when your blood glucose levels are low and then store it when your blood glucose levels are high. In people with Type 2 diabetes, this process is completely impaired and the liver produces too much glucose.
  • GLP-1 can cause you to feel full, so it increases early satiety. It does this by slowing gastric emptying, slowing the rate of food moving from your stomach into your small intestines. By doing this, the rate of absorption of nutrients into the blood stream is slowed, including glucose, which may reduce your food intake.


How is Trulicity (Dulaglutide) different from GLP-1?

GLP-1 is a naturally occurring hormone found in all people. Trulicity (Dulaglutide) shares 90% of the same structure as human GLP-1 but is synthetically manufactured. Dulaglutide has been modified structurally to prevent it from being broken down by an enzyme in the blood called dipeptidyl peptidase-4 or DPP-4.

The formulation causes Trulicity to have a long duration of action and it is an example of a once weekly GLP-1. Another example of long acting GLP-1 is Ozempic (generic name Semaglutide).

Drugs that block the action of DPP-4 are called DPP-4 inhibitors and these have been used in the treatment of type 2 diabetes for many years. By blockimg the enzyme that breaks down naturally occurring GLP-1 they increase amount of GLP-1 in the body. (Dipeptidyl peptidase-4 (DPP-4) inhibitors for the treatment of type 2 diabetes mellitus). Examples of DPP-4 inhibitors include:

  • sitagliptin (Januvia)
  • valdagliptin (Galvus)
  • saxagliptin (Onglyza)
  • linagliptin (Tradjenta)
  • alogliptin (Nesina)


How often is Trulicity administered ?

Trulicity is administered once a week as injection under the skin.

To help remember what day to take your Trulicity, it is useful to have a reminder in your phone each week. It does not matter what day of the week to administer Trulicity (Dulaglutide) so it is best to choose a day that best fits a person''t forget. You administer it once every Sunday and that''m going to talk about Dulaglutide or Trulicity and specifically I want to show you how to use this pen so you can administer it safely and easily. So this is a new product used widely around the world and it contains a compound called dulaglutide and dulaglutide is essentially a naturally occurring human chemical called GLP-1 or Glucagon-like peptide 1. GLP-1s are in essence chemicals that the body produces in response to food.

It does 3 things, if you eat, it increases insulin production out of the pancreas, which helps lower your blood sugar after eating.

It also interestingly reduces the amount of sugar that the liver is producing. Typically the liver produces sugar, and it does this when you are in periods of starvation. So if you like, it is a storage mechanism that can release sugar when your blood sugars are low and then suck it up when your blood sugars are high. In people with Type 2 diabetes, that process is completely impaired and the liver just produces too much sugar. The third action, which I think is also critical, is it causes a person to feel full. In other words, it increases satiety. So after eating, what you want to do is increase your insulin reduce the liver sugar and feel full.

All of those 3 things are done by GLP-1 and this is a version of GLP-1. One of the clever things about re-packaging GLP-1 and changing slightly the way the molecule is and binding it up to, in this case, an antibody, is that you can change the duration of action.

Trulicity is given once a week. So in order to do it effectively, you choose a day, let''t forget. You administer it once a week, and that''s just look a little bit about how to administer it. On the end of this is a cap, and you would remove the cap. And the needle actually is there but you won''t fire the product accidentally when you don''s done when you hear the second click. Which will happen any second now. There it is. That is safely and easily disposed of in the bins in the normal way.

But beyond that simple, easy and likely to achieve for a lot of people pretty good sugar control with a bit of weight loss.

Dr Sultan




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