Trulicity, commonly known for its role in managing type 2 diabetes, also offers significant benefits for weight loss. This article breaks down the scientific principles behind Trulicity and weight loss, focusing on how it regulates insulin levels and impacts appetite.
Whether you’re a healthcare professional or a patient, understand what Trulicity can do for weight management.
What is Trulicity
Trulicity (dulaglutide) is approved by the Food and Drug Administration (FDA) as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.
Trulicity and Weight loss
While it is not specifically approved for weight loss, Trulicity has been associated with reductions in body weight in clinical trials.
The weight loss observed with Trulicity is consistent with the class effect of glucagon-like peptide-1 (GLP-1) receptor agonists, which includes drugs like liraglutide and semaglutide that have been approved for weight management in certain contexts.
A systematic review and meta-analysis found that subcutaneous dulaglutide administration in patients with type 2 diabetes mellitus led to significant reductions in body weight, body mass index (BMI), and waist circumference compared to placebo. The weight loss effect was dose-dependent and more pronounced in individuals with obesity compared to those who were overweight.
However, it is important to note that while GLP-1 receptor agonists like dulaglutide can lead to weight loss, they are not primarily weight loss drugs and should be used in the context of their approved indications. When considering the use of dulaglutide for weight loss or, indeed, any GLP-1 receptor agonist for weight management in patients with type 2 diabetes, it is essential to evaluate the individual patient’s clinical profile and treatment goals.
The American Association of Clinical Endocrinology (AACE) Consensus Statement on the comprehensive type 2 diabetes management algorithm does not list Trulicity as an FDA-approved agent for weight loss but does mention other GLP-1 receptor agonists such as semaglutide 2.4 mg and liraglutide 3 mg for this indication.
Studies that support the use of Trulicity for weight loss
The medical literature includes studies evaluating Trulicity for weight loss in patients with type 2 diabetes mellitus (T2DM). A pilot study reported that the combination of dulaglutide and a low-energy diet was well-tolerated, resulting in significant weight loss and improved glycemic control in individuals with obesity and T2DM.
Another study found that dulaglutide led to reductions in body weight and HbA1c in real-world T2DM patients, with more pronounced effects in GLP-1 receptor agonist-naïve patients and those with shorter disease duration.
A systematic review and meta-analysis of randomized controlled trials (RCTs) concluded that subcutaneous dulaglutide administration in T2DM reduces body weight, body mass index (BMI), and waist circumference, with the degree of weight loss influenced by the dose and duration of dulaglutide administration.
Additionally, a retrospective multicenter study found that dulaglutide significantly reduced body weight and BMI, with the most frequently reported adverse events being gastrointestinal disorders.
These findings suggest that dulaglutide, while not approved solely for weight loss, may have a secondary effect on weight reduction when used in the context of T2DM management.
Mechanism of action of Trulicity?
Trulicity (dulaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist. Its mechanism of action involves binding to the GLP-1 receptor, a membrane-bound cell-surface receptor coupled to adenylyl cyclase in pancreatic beta cells. Dulaglutide activates the GLP-1 receptor, leading to an increase in intracellular cyclic AMP (cAMP) in beta cells, resulting in glucose-dependent insulin release.
Trulicity (dulaglutide) ‘s metabolic effects in the body include stimulating glucose-dependent insulin secretion and reducing glucagon secretion, which is central to its glycemic control properties. Dulaglutide increases fasting insulin and C-peptide concentrations, indicating its role in enhancing endogenous insulin secretion. It also reduces fasting glucagon concentration, which contributes to lowering hepatic glucose output.
Additionally, Trulicity causes a delay in gastric emptying, which can contribute to reduced postprandial glucose levels.
Furthermore, Trulicity has been shown to affect body weight, with consistent reductions from baseline in body weight observed in clinical trials. These effects are dose-dependent, with higher doses leading to more significant weight loss.
Dulaglutide also has favourable effects on cardiovascular risk factors, with improvements noted in serum high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C in patients with type 2 diabetes.
Common side effects associated with Trulicity use for weight loss
The common side effects associated with the use of Trulicity (dulaglutide) for glycemic control in type 2 diabetes, which may also be relevant when considering its effects on weight loss, include gastrointestinal-related adverse events such as nausea, diarrhoea, vomiting, abdominal pain, and decreased appetite.
Additionally, the prescribing information for Trulicity warns of the risk of thyroid C-cell tumours and pancreatitis, among other serious reactions.
Potential long-term effects of using Trulicity for weight loss
The potential long-term effects of using Trulicity (dulaglutide) for weight loss, outside of its approved indication for type 2 diabetes management, are not well characterized in the medical literature. However, it is known that GLP-1 receptor agonists, like dulaglutide, can have gastrointestinal side effects such as nausea, vomiting, and diarrhoea.
Additionally, there is a boxed warning for the risk of thyroid C-cell tumours, and it is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Long-term use of GLP-1 receptor agonists has also been associated with a reduction in cardiovascular events in patients with type 2 diabetes.
The sustainability of weight loss effects over time is uncertain, as some studies have shown that the initial beneficial effects on HbA1c and weight may not be maintained beyond a certain period.
Conclusion
In conclusion, Trulicity offers promising benefits for weight loss, especially for those managing type 2 diabetes.
However, while GLP-1 receptor agonists like dulaglutide can lead to weight loss, they are not primarily weight loss drugs and should be used in the context of their approved indications. When considering the use of dulaglutide or any GLP-1 receptor agonist for weight management, it is essential to evaluate the individual patient’s clinical profile and treatment goals.
Disclaimer: This article is for informational purposes only and should not replace professional medical advice. If you have specific concerns or medical conditions, it is recommended to consult with a healthcare professional for personalised guidance and support.
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