• Although dulaglutide is not a weight loss drug, some people may lose weight.
• One of the ways dulaglutide works is by helping to make you feel full after a meal.
• People more likely to lose weight include those with a higher starting weight and a longer duration of gastrointestinal side effects.

Dulaglutide is an injectable medicine that is used to improve blood sugar control in adults over the age of 18 with type 2 diabetes. It is usually prescribed after oral medications for diabetes have not worked or have stopped working.

Dulaglutide is injected under the skin once a week, preferably on the same day each week at the same time. Each injection will help control blood sugars for one week. Dulaglutide is only effective in people with type 2 diabetes.

Can dulaglutide make you lose weight?

Research has shown that many people lose, on average, two to six pounds while taking dulaglutide. However, some people gained weight. Specific studies have shown:

• Dulaglutide was associated with a greater weight loss (3.23kg on average) compared to insulin glargine in 588 patients also taking insulin lispro. 49% of people in the study administered dulaglutide did not gain weight compared with only 19% administered insulin glargine.
• In the AWARD-1 trial, people gained an average of 0.2kg in weight with dulaglutide 0.75mg
• In the AWARD-3 trial weight loss with dulaglutide was similar to metformin
• In the AWARD -4 trial, weight loss with dulaglutide 1.5mg was 0.87kg, while dulaglutide 0.75mg was weight neutral at 26 weeks
• In the AWARD-6 trial, average weight loss was 2.8kg with dulaglutide 1.5mg compared to 3.6kg with liraglutide
• In the AWARD-11 trail, the average weight loss after 36 weeks was 4.7kg (10.4 pounds) with dulaglutide 4.5mg; 4kg (8.8 pounds) with dulaglutide 3mg; and 3kg (6.8 pounds) with dulaglutide 1.5mg.

Although overall treatment with GLP-1 receptor agonists is associated with weight loss, this varies among individuals, and 15 to 30% of people will gain weight.

People more likely to lose weight include those with a higher starting weight and a longer duration of gastrointestinal side effects.

How does dulaglutide work?

Dulaglutide belongs to a class of medicines called GLP-1 receptor agonists. It may also be called an incretin mimetic.

Dulaglutide works by mimicking the functions of natural incretin hormones in the body that help keep blood sugar levels under control, especially immediately following a meal. Incretin hormones are gut peptides that are secreted from the stomach when food is eaten. They also stimulate the secretion of insulin in response to high blood glucose levels.

Two incretin hormones are known as GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1). In people with type 2 diabetes, this natural incretin effect is diminished or no longer present. However, it can be stimulated with pharmacological agents, such as Dulaglutide.

Dulaglutide shares 90% of the same structure as human GLP-1 but is man-made. It has been modified so that it can last in the body for a long time (approximately one week) and not be broken down by an enzyme naturally present in the blood, called dipeptidyl peptidase-4 or DPP-4.

Dulaglutide acts like GLP-1 and binds to GLP-1 receptors, stimulating insulin release from the pancreas, reducing the amount of glucose that the liver produces, and making you feel full by slowing gastric emptying.