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Dulaglutide

Also known as: Trulicity, LY2189265, GLP-1 RA weekly

GLP-1 receptor agonist (glucagon-like peptide-1 receptor agonist); long-acting Fc-fusion peptide analog; antidiabetic agent; antiobesity agent (investigational)

Research chemicalLast updated: October 10, 2026Preclinical data only — no human trials
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What it is

Dulaglutide (Trulicity) is a once-weekly injection used by people with type 2 diabetes to lower blood sugar and reduce the risk of serious heart events. Approved in the US since 2014, it is one of the most widely prescribed diabetes medicines in its class, with a large cardiovascular outcomes trial supporting its use in people at elevated heart risk.

The scientific side

Dulaglutide is described as a recombinant DNA-produced long-acting GLP-1 receptor agonist in which the native 7–37 amino acid GLP-1 peptide is fused via a small peptide linker to a modified human IgG4 Fc fragment, producing a large molecule (approximately 59.7 kDa) that resists dipeptidyl peptidase-4 (DPP-4) cleavage and retains activity with once-weekly subcutaneous dosing. Upon binding the GLP-1 receptor on pancreatic beta cells, dulaglutide activates adenylyl cyclase, raising intracellular cyclic AMP and potentiating glucose-stimulated insulin secretion in a glucose-dependent fashion, meaning it stimulates insulin release only when blood glucose is elevated, substantially reducing hypoglycemia risk. Simultaneously, dulaglutide suppresses pancreatic glucagon secretion from alpha cells in a glucose-dependent manner, reducing hepatic glucose output during hyperglycemic states. Beyond the pancreas, dulaglutide delays gastric emptying, reducing the rate of postprandial glucose absorption and blunting postmeal glucose excursions. Central GLP-1 receptor activation in the hypothalamus and brainstem promotes satiety signaling, reduces appetite, and contributes to the weight loss observed in clinical trials. In the REWIND cardiovascular outcomes trial (9,901 participants, median follow-up 5.4 years), dulaglutide 1.5 mg weekly reduced the primary composite cardiovascular endpoint (non-fatal MI, non-fatal stroke, or cardiovascular death) versus placebo (HR 0.88, 95% CI 0.79–0.99, p=0.026), making it the only GLP-1 receptor agonist outcomes trial to demonstrate significant cardiovascular benefit in a predominantly primary prevention population. REWIND post-hoc analyses also identified dulaglutide-associated reductions in composite kidney outcomes (HR 0.75, p=0.004), slower eGFR decline (-1.37 vs. -1.56 mL/min/1.73 m²/year), and attenuation of cardiovascular biomarker rises (NT-proBNP, GDF-15) that partially mediate the observed CV benefit. Additional mechanistic data from head-to-head trials (SUSTAIN 7, AWARD-5) confirm HbA1c reductions of 0.99–1.4% and weight losses of 2.9–3.0 kg with the approved 1.5 mg dose at 24–104 weeks.

Class: GLP-1 receptor agonist (glucagon-like peptide-1 receptor agonist); long-acting Fc-fusion peptide analog; antidiabetic agent; antiobesity agent (investigational)

Administration & storage

Administration
Subcutaneous injection into the abdomenupper thighor upper arm using the single-dose prefilled autoinjector penInjection site should be rotated each week; do not use the same site two weeks in a rowDo not inject into skin that is damagedbruisedor has a rashIntravenous or intramuscular administration has not been studied and is not indicated
Storage
Store in original carton in refrigerator at 2–8°C (36–46°F) until use. May be stored at room temperature (up to 30°C/86°F) for up to 14 days. Do not freeze. If frozen, discard. Protect from light. Do not use if solution is cloudy, colored, or contains particles.
Cautions
BOXED WARNING (FDA): GLP-1 receptor agonists including dulaglutide cause thyroid C-cell tumors in rodents at clinically relevant exposures. Although a causal relationship in humans has not been established, dulaglutide is CONTRAINDICATED in patients with personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).,Risk of acute pancreatitis: post-marketing reports of fatal and non-fatal acute pancreatitis. Discontinue promptly if pancreatitis is suspected; do not restart if confirmed.,Hypoglycemia: when used with insulin or a sulfonylurea, dosage reduction of the insulin or sulfonylurea may be required to reduce hypoglycemia risk. Dulaglutide alone has a low intrinsic hypoglycemia risk due to its glucose-dependent mechanism.,Acute kidney injury: reported, particularly in patients experiencing gastrointestinal adverse reactions leading to dehydration. Use caution in patients with renal impairment.,Serious hypersensitivity reactions (anaphylaxis, angioedema) have been reported; discontinue if suspected.,Diabetic retinopathy complications reported in patients with a history of diabetic retinopathy, associated with rapid HbA1c improvement — monitor for retinopathy worsening.,Heart rate increase: a mean increase of 2–3 beats per minute reported; use caution in patients with underlying tachyarrhythmias.,Do not use in patients with personal or family history of MTC or MEN 2; do not use in type 1 diabetes or for treatment of diabetic ketoacidosis.

Legal & regulatory status

US FDA

FDA-approved (NDA 125469) as Trulicity (dulaglutide injection) for adults with type 2 diabetes mellitus to improve glycemic control as an adjunct to diet and exercise, and to reduce the risk of major adverse…

WADA

Dulaglutide is not listed on the WADA Prohibited List. It is a prescription therapeutic agent used solely for type 2 diabetes management and cardiovascular risk reduction. No evidence of performance-enhancing misuse in…

Health Canada

Approved in Canada as Trulicity (dulaglutide) by Health Canada (DIN 02429497) for adults with type 2 diabetes to improve glycemic control and to reduce the risk of major adverse cardiovascular events in those with…