Trulicity (dulaglutide) is a prescription medication primarily indicated for the management of type 2 diabetes. It belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. While it is not officially approved by the Food and Drug Administration (FDA) for weight loss, Trulicity has been observed to promote weight loss in some individuals, leading clinicians to prescribe it off-label in certain cases to support weight loss and metabolic health in people with obesity or overweight. This article explores how Trulicity works, its effectiveness for weight loss, clinical study results, potential side effects, and important considerations for those considering its use.
What is Trulicity?
Trulicity is the brand name for dulaglutide, a GLP-1 agonist. It is administered as a once-weekly injectable medication and is one of several GLP-1 medications. Trulicity is FDA-approved for managing type 2 diabetes by helping lower blood sugar levels. It achieves this by stimulating insulin release and slowing down digestion, which provides better control over glucose levels.
How Trulicity Works for Weight Loss
Trulicity, like other GLP-1 drugs, mimics the natural incretin hormones produced by the body. Incretin hormones signal to the brain, endocrine, and gastrointestinal systems that food has been consumed. This results in a cascade of hormonal and neurotransmitter responses that effectively communicate feelings of satiety (fullness) and slow down the rate at which food leaves the stomach, helping individuals feel fuller for longer.
The medication also improves blood sugar levels in people with impaired glucose tolerance or diabetes. Trulicity helps the pancreas release insulin in response to high levels of sugar in the blood after eating and can limit how much sugar gets into the blood from the liver. Optimal blood sugar levels enable the body to burn fat for energy instead of storing it, which helps with weight loss.
Trulicity increases the time it takes for food to move through the stomach, preventing sudden spikes in blood sugar levels after eating. This also contributes to a prolonged feeling of fullness, reducing overall food intake.
Read also: Choosing Between Trulicity and Victoza
Clinical Studies on Trulicity for Weight Loss
Several clinical studies have explored the effects of Trulicity on weight loss. These studies provide insights into the efficacy of Trulicity in promoting weight loss, particularly in individuals with type 2 diabetes.
AWARD-11 Clinical Trial (2018-2020)
The AWARD-11 trial evaluated the effects of different doses of Trulicity on weight and glycemic control in patients with type 2 diabetes. The study compared 1.5 mg, 3 mg, and 4.5 mg doses of Trulicity over 52 weeks. The results indicated that patients taking the higher doses (3 mg and 4.5 mg) experienced greater weight loss compared to those on the standard 1.5 mg dose. Specifically:
- The 4.5 mg group lost an average of 4.7 kg (10.4 lbs).
- The 3 mg group lost an average of 3.7 kg (8.2 lbs).
- The 1.5 mg group lost an average of 2.7 kg (6 lbs).
AWARD-6 Trial (2012-2014)
The AWARD-6 trial compared Trulicity (dulaglutide) 1.5 mg with another GLP-1 medication, liraglutide (brand names Saxenda and Victoza) 1.8 mg, over 26 weeks in patients with type-2 diabetes. While the primary goal was to assess blood sugar control, weight loss was also evaluated. Both medications resulted in modest weight loss:
- Trulicity (dulaglutide) users lost an average of 2.9 kg (6.4 lbs).
- Liraglutide users lost an average of 3.6 kg (7.9 lbs).
REWIND Study (2011-2018)
The REWIND study evaluated the long-term cardiovascular outcomes of Trulicity in people with type 2 diabetes, with weight loss as a secondary outcome. Over a median of 5.4 years, patients taking Trulicity experienced a modest but sustained weight loss of around 1.5 kg (3.3 lbs) compared to the placebo group.
How to Use Trulicity
Trulicity is administered via a pre-filled pen as a once-weekly injection. Detailed instructions are typically provided by a healthcare provider. A high-level overview includes:
Read also: Using Trulicity for Weight Management
- Prepare the injection site: Choose an area such as the stomach, thigh, or upper arm, and clean the area with alcohol.
- Uncap the pen: Remove the grey base cap of the pen.
- Place the pen against the skin: Hold the pen at a 90-degree angle to the skin.
- Press the button: Once a click is heard, the injection has started. Keep the pen in place until the green bar stops moving, which takes about 5-10 seconds.
Many people begin to notice improvements in blood sugar levels within a few weeks of starting Trulicity. However, the weight loss effects may take longer, with some individuals reporting changes after 4 to 6 weeks. Trulicity is typically prescribed in doses starting at 0.75 mg once a week, with adjustments made based on the individual’s response. A healthcare provider may recommend increasing the Trulicity dose if the initial dose isn’t providing adequate blood sugar control or if the desired weight loss isn’t achieved. The standard dosage increase is from 0.75 mg to 1.5 mg once weekly, but it is essential to follow the healthcare provider’s advice on timing and dosage adjustments.
Taking Trulicity with Other Medications
Trulicity and Metformin
Trulicity and metformin are often used together, especially in managing type 2 diabetes. Metformin improves the body’s response to insulin and reduces glucose production in the liver, while Trulicity helps lower blood sugar by stimulating insulin secretion and slowing digestion. Combining these medications can effectively manage blood sugar levels and potentially aid weight loss. However, some people may experience side effects like gastrointestinal discomfort when starting this combination.
Trulicity and Insulin
Trulicity can be taken with insulin, but it’s important to follow the guidance of a healthcare provider. Trulicity helps manage blood sugar differently by stimulating insulin release and reducing appetite. Combining it with insulin can improve blood sugar control, but it may also increase the risk of low blood sugar (hypoglycemia). The healthcare provider may adjust the insulin dosage to avoid this. It is important to monitor blood sugar closely when using both medications.
Trulicity Side Effects
The most common side effects of Trulicity include:
- Nausea
- Constipation
- Diarrhea
- Stomach discomfort
- Vomiting
- Decreased appetite
- Indigestion
- Fatigue
These side effects typically subside within 3-4 weeks after starting the medication.
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Managing Trulicity Side Effects
To reduce nausea and stomach discomfort with Trulicity, consider the following tips:
- Eat blander foods.
- Refrain from eating fatty, processed, or greasy foods.
- Eat smaller meals or stick to smaller portion sizes.
- Stay active.
If side effects become bothersome or don’t go away, consult a healthcare provider. Seek immediate medical care for any allergic reactions, such as anaphylaxis or shortness of breath.
Risks and Warnings Associated with Trulicity
In rare cases, Trulicity has been associated with an increased risk of thyroid cancer. Individuals with a family history of thyroid cancer or certain other risk factors should consult their clinician before starting the medication. Discuss the potential risks and benefits with a healthcare provider. GLP-1 medications pose a relatively small risk of hypoglycemia (low blood sugar), which is typically only a concern when used in conjunction with other diabetes medications such as insulin.
Trulicity vs. Other Medications
Mounjaro
Mounjaro is a more effective drug than Trulicity. Mounjaro, in addition to mimicking GLP-1, also mimics the actions of GIP and is a dual-action type 2 diabetes and weight-loss injection. Participants on 5mg of Mounjaro lost 7.8% of their weight, those on 10mg lost 11%, and those on 15mg lost 13.9%. However, Trulicity may lead to less feelings of nausea than Mounjaro.
Ozempic, Wegovy, and Zepbound
Other GLP-1 receptor agonists, such as Ozempic (semaglutide) and Wegovy (semaglutide), are approved for weight loss. Zepbound (tirzepatide) is a combination GLP-1 with a glucose-dependent insulinotropic peptide (GIP), offering superior weight loss results compared to earlier GLP-1 drugs.
Trulicity for Weight Loss Takeaways
Trulicity (dulaglutide) is primarily approved for treating type 2 diabetes but may be prescribed off-label for weight loss. It works by mimicking incretin hormones, promoting satiety, and improving blood sugar control. Clinical studies show modest weight loss with Trulicity, particularly at higher doses. Common side effects include nausea, diarrhea, and stomach discomfort, which usually subside over time.
When considering Trulicity for weight loss, it is important to discuss the potential benefits and risks with a healthcare provider. The amount of weight loss may vary depending on individual factors such as BMI and dosage. Combining Trulicity with healthy lifestyle changes, such as diet and exercise, can enhance its effectiveness.
While Trulicity is not a weight loss drug, people receiving it may lose weight. Higher doses of Trulicity typically result in more weight loss. It is essential to use Trulicity under the guidance of a healthcare professional to ensure its safe and effective use.
Additional Considerations
- Individual Responses: Individual responses to medications can vary.
- Lifestyle Changes: Medications are not a substitute for healthy lifestyle changes.
- Cost: The cost of Trulicity can vary depending on the source and duration of use.
- Off-Label Use: Trulicity is officially approved for the treatment of Type 2 diabetes in combination with diet and exercise and for the reduction of cardiovascular mortality.