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Hormones & metabolism

Dulaglutide

EvidenceFDA approved

ClassGLP-1 receptor agonist

Dulaglutide is an FDA-approved once-weekly GLP-1 receptor agonist for type 2 diabetes. Learn how it works, what trials showed, and its cardiovascular role.

Reviewed by: William Maish, MD MBA MPH, Clinical Product Lead
Published: October 5, 2026
Last updated: October 5, 2026

Key takeaway

Dulaglutide is a once-weekly GLP-1 receptor agonist built by fusing two GLP-1 analog chains to an antibody fragment, which extends its action to about five days. It was approved for type 2 diabetes in 2014 and gained a cardiovascular indication in 2020 after the REWIND trial showed a roughly 12% reduction in major cardiovascular events. It remains on the market as Trulicity.

At a glance

FDA status	FDA-approved GLP-1 peptide, sold as Trulicity for type 2 diabetes
How it's taken	Once-weekly injection that also lowers cardiovascular risk
Research	In trials, lowered blood sugar and reduced major cardiovascular events by about 12%
Evidence strength	FDA approved

What is dulaglutide?

Dulaglutide is a GLP-1 receptor agonist¹, a peptide that mimics the natural gut hormone GLP-1. It is built by attaching two GLP-1 analog chains to a fragment of an antibody, which makes the molecule large and long-lasting enough to be injected only once a week.

It is made by Eli Lilly and sold as Trulicity, given as a once-weekly subcutaneous injection.

How does it work?

Dulaglutide lowers blood sugar and curbs appetite by activating the GLP-1 receptor, mimicking a gut hormone the body releases after eating. Through that receptor it prompts the pancreas to release insulin when blood sugar is high. Because this effect is glucose-dependent, meaning it works mainly when blood sugar is already elevated, dulaglutide on its own carries a low risk of hypoglycemia. It also lowers glucagon (a hormone that raises blood sugar), slows the rate at which the stomach empties, and acts on appetite centers to reduce food intake.

The antibody fragment it is attached to keeps it in the blood for about five days, which is what allows once-weekly dosing. In its trials, it typically lowered A1c by around 1.5%². In the REWIND cardiovascular outcomes trial, it reduced major cardiovascular events by about 12%³ in people with type 2 diabetes.

Is it FDA-approved?

Yes. Dulaglutide's approval has expanded in stages:

Year	Approval
2014	Type 2 diabetes
2020	Reducing the risk of major cardiovascular events in adults with type 2 diabetes, whether or not they already have heart disease
2022	Children 10 and older with type 2 diabetes

It remains on the market as Trulicity.

What is dulaglutide prescribed for?

Dulaglutide is prescribed to improve blood sugar control in adults and children 10 and older with type 2 diabetes, alongside diet and exercise, and to reduce cardiovascular risk in adults with type 2 diabetes. It is not a treatment for type 1 diabetes. It should not be used by people with a personal or family history of medullary thyroid carcinoma¹ or Multiple Endocrine Neoplasia syndrome type 2.

What are the side effects?

The most common side effects are gastrointestinal, and they are usually strongest when the dose is increased:

Nausea
Diarrhea
Vomiting
Abdominal pain
Decreased appetite
Fatigue

Less common but more serious risks include:

Thyroid C-cell tumors: dulaglutide carries a boxed warning¹ based on rodent studies. It is not known whether this happens in humans.
Pancreatitis, or inflammation of the pancreas
Gallbladder problems, including gallstones
Acute kidney injury, usually from dehydration caused by vomiting or diarrhea
Low blood sugar, especially when combined with insulin or a sulfonylurea
Worsening of diabetic retinopathy
Serious allergic reactions
Severe stomach and bowel side effects
Food or liquid entering the lungs during anesthesia

More for hormones & metabolism

Sources: FDA prescribing information for Trulicity (dulaglutide); and the REWIND cardiovascular outcomes trial (Gerstein et al., The Lancet, 2019, DOI: 10.1016/S0140-6736(19)31149-3³), indexed on PubMed. This document is educational and does not constitute medical advice.