For some people with type 2 diabetes, needles or injections represent a barrier to better diabetes control. With the Trulicity (dulaglutide) pen, injecting has never been simpler! And now there is an additional important benefit. Trulicity not only helps those with cardiovascular disease (CVD), but it also prevents CVD in those without it! Coupled with healthy eating and regular activity, once weekly Trulicity can be used by itself or in combination with other diabetes medications to help control diabetes.
How Does Trulicity Work?
Trulicity is a glucagon like peptide-1 receptor analog (GLP-1 RA). Even though it is synthetic, it acts similarly to the hormone GLP-1 naturally produced by the body, which is deficient in type 2 diabetes. GLP-1 normally is released from the intestines when carbohydrates and fats are consumed. It helps enhance pancreatic insulin release, slows the stomach of emptying food, and suppresses appetite. This is known as glucose-dependent insulin release and is important in preventing low blood glucose (hypoglycemia) events. In addition to increasing insulin release, Trulicity decreases glucagon production especially after eating, which helps to limit elevated glucose levels. In addition to affecting the pancreas, Trulicity also works in the brain. Here it acts to suppress appetite, which leads to eating less and results in weight loss. Lastly, Trulicity works in the stomach. In people with type 2 diabetes, the stomach often empties the nutrients into the rest of the intestines too rapidly. GLP-1 RAs help slow and regulate these actions, which in turn controls glucose concentrations after eating.
How Is Trulicity Used?
Trulicity is formulated in an easy to use pen. There is no mixing, waiting, inserting a needle or any extra steps! Pick any day of the week that works best for you and make that your “Trulicity Day.” It’s as easy as uncapping, placing the pen on an injection site, unlocking, and pressing the auto injector button. After pressing to inject, hold for 5-10 seconds until you hear the release click. You never see the needle! Your doctor or pharmacist will help you decide what the best injection site will be for you; typically this is your stomach, thigh or upper arm. You should change the injection site week-to-week by either changing the area or rotating within the same area. Once used, the pen can be disposed of in a sharps container. New pens should be stored in a refrigerator, away from light, and in the original box.
What Can You Expect?
Trulicity lowers both fasting and postprandial (after meal) glucose in people with diabetes. A reduction of A1c from 0.7-1.6% can be expected when used by itself or in combination with other medications. Additionally, many patients have experienced weight loss while on this medication. The most common side effects of Trulicity include upset stomach, nausea and sometimes diarrhea, and feeling “fuller faster”. The best way to avoid these side effects is to eat smaller meals. These initial symptoms usually improve after a few weeks on the medication, as your body is getting used to it. A rare side effect with all GLP-1 RAs is pancreatitis. If you experience stomach pain that you may even feel in the lower back, severe vomiting, and/or fever, go to the ER immediately. Because of how Trulicity works, it poses little risk of causing low blood glucose. However, combining Trulicity with drugs such as insulin or sulfonylureas (glipizide or glimepiride) may increase the risk of low blood glucose.
Is Trulicity Right for You?
Trulicity will help achieve glycemic control in type 2 diabetes patients along with healthy food choices, smaller meals and exercise. Although not recommended as the first medication to treat diabetes (metformin or Glucophage are usually first line therapy), it typically leads to a significant decrease in A1c, especially when coupled with other diabetes medications like metformin. Studies have also demonstrated Trulicity reduces cardiovascular death, nonfatal heart attacks, nonfatal strokes in both in people with type 2 diabetes with cardiovascular disease (CVD) AND those without CVD. As a result, the FDA recently approved Trulicity to treat both of these groups of patients: type 2 diabetes with established CVD (secondary prevention) AND as primary prevention for CVD.
Proper blood glucose control is important to prevent long-term complications of diabetes such as damage to blood vessels and nerves. Because of Trulicity’s unique once-weekly administration, it may be preferred by patients who have difficulty remembering to take their current medication or who want more flexibility.
Before using Trulicity, it is important to inform your doctor of certain conditions. Tell your provider if you have any history of pancreatitis, severe gastrointestinal (GI) disease, thyroid cancer, or family history of thyroid cancer. As always, it’s important to let your provider know of all prescription, over-the-counter, and herbal medications you are taking.
The Bottom Line
Trulicity offers a simple, once-weekly way to control type 2 diabetes and prevent CVD or help with existing CVD. This GLP-1 RA acts in many ways to help achieve glucose control and a healthier self. Trulicity is truly and simply administered without seeing a needle, it doesn’t cause weight gain and it helps and protects from CVD. Trulicity really does equal simplicity in the fight against type 2 diabetes!