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Metformin Case

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Question / Problem: What is the evidence to recommend Trulicity (dulaglutide) to a patient who has uncontrolled glucose control, and is on metformin and insulin (levemir) and non- adherence to the insulin.

Response: The trulicity is a non-insulin injectable with dosing regimen of once weekly dosing. These agents work by activating GLP-1 receptors in the pancreas, which leads to enhanced insulin release and reduced glucagon release-responses that are both glucose-dependent-with a consequent low risk for hypoglycemia. Effects on GLP-1 receptors in the CNS and the gastrointestinal tract cause reduced appetite and delayed glucose absorption due to slower gastric emptying.1 Dulaglutide 1.5 mg and 0.75 mg is studied in patients is age groups of age > 65 and < 65 years to achieve the HbA1c target of <7% ranged from 53 to 78% for dulaglutide 1.5 mg and from 37 to …show more content…

In the dulaglutide 1.5 mg change in body weight was from 0.9-3.0 kg and 0.2-2.6 kg for dulaglutide 0.75 mg. 2 One of the study conducted in Hispanic/Latino patients receiving dulaglutide 1.5 and 0.75 mg to see the reduction in HbA1c. Hispanic/Latino patients receiving dulaglutide 1.5 mg had a reduction in HbA1c of 1.25%, and dulaglutide 0.75 mg had a reduction of 1.07%. Dulaglutide improved glycemic control with the potential for weight loss in Hispanic/Latino patients with T2D. Dulaglutide was well tolerated and had a low risk of hypoglycemia when used without insulin secretagogues or insulin.3 Dulaglutide is available as a single-dose automatic self-injecting device, which has a low volume, does not need reconstitution, and avoids patient handling of the needle. No dose adjustment requires based on weight, sex, age,

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