Drugdu.com expert's response:

Dulaglutide is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist with significant glucose-lowering effects, particularly suitable for patients with type 2 diabetes mellitus. Its specific manifestations are as follows:

I. Core Glucose-Lowering Mechanisms

Promotion of Insulin Secretion: By mimicking the body's natural GLP-1, dulaglutide activates GLP-1 receptors, increasing cyclic adenosine monophosphate (cAMP) levels in pancreatic β-cells. This precisely stimulates insulin secretion when blood glucose levels rise (e.g., after meals), thereby lowering blood glucose.

Inhibition of Glucagon Release: Glucagon is a hormone that raises blood glucose. Dulaglutide suppresses its secretion, further reducing hepatic glucose output and aiding in glycemic control.

Delay of Gastric Emptying: By slowing the passage of gastric contents into the small intestine, dulaglutide prolongs carbohydrate absorption time, preventing sharp postprandial blood glucose spikes and achieving stable glycemic control.

II. Clinical Efficacy Data

Significant Reduction in Glycated Hemoglobin (HbA1c): Multiple studies demonstrate that after 24 weeks of dulaglutide treatment, HbA1c levels decrease by an average of 0.5%–1.5%, with some patients experiencing reductions of up to 2.0%. This indicator reflects long-term glycemic control, with a more pronounced decline compared to traditional oral hypoglycemic agents (e.g., metformin).

Improvement in Fasting and Postprandial Blood Glucose: Dulaglutide effectively lowers both fasting blood glucose and postprandial glucose peaks, showing particular efficacy in patients with significant postprandial glucose fluctuations.

Weight Loss: On average, patients lose approximately 3–4 kg after 12 weeks of use, primarily due to appetite suppression and reduced gastrointestinal motility, which lowers caloric intake. Weight loss enhances insulin sensitivity, further strengthening glycemic control.

III. Additional Health Benefits

Cardiovascular Protection: Dulaglutide may reduce the risk of major cardiovascular events (e.g., myocardial infarction, stroke), improve arterial vasodilation, and decrease atherosclerosis risk.

Preservation of Pancreatic β-Cell Function: Long-term use slows the decline of pancreatic β-cell function, supporting sustained long-term glycemic stability.

Comprehensive Metabolic Improvements: Promotes cholesterol catabolism, lowering plasma cholesterol levels.

Inhibits ventricular remodeling and improves left ventricular function.

IV. Safety and Side Effects

Common Side Effects: Gastrointestinal Reactions: Nausea, vomiting, and diarrhea (more frequent during initial treatment and diminishing over time).

Hypoglycemia Risk: Low incidence when used alone, but caution is advised when combined with other hypoglycemic agents.

Injection Site Reactions: Such as redness or itching (mitigated by rotating injection sites).

Contraindicated Populations: Patients with a personal or family history of medullary thyroid carcinoma. Patients with type 2 multiple endocrine neoplasia syndrome. Adolescents under 18 years old, pregnant women, and breastfeeding mothers.

V. Usage Recommendations

Suitable Populations: Patients with type 2 diabetes mellitus, especially those who are obese or have comorbid cardiovascular disease. Patients requiring long-term glycemic control who prefer the convenience of once-weekly injections.

Monitoring During Treatment: Regularly monitor blood glucose, HbA1c, and weight changes. Seek prompt medical attention for severe side effects (e.g., persistent vomiting, hypoglycemia).

Lifestyle Integration: Combining dulaglutide with dietary modifications (avoiding high-sugar, high-fat foods) and regular exercise enhances its glucose-lowering effects.