Overview
A GLP-1 molecule bolted onto an antibody fragment to slow its clearance — a different half-life strategy from the fatty-acid acylation used by semaglutide. Its distinguishing evidence is the REWIND trial, which showed cardiovascular benefit in a mostly primary-prevention population.
FDA ApprovedFDA-approved for type 2 diabetes and for cardiovascular risk reduction in type 2 diabetes.
| Regulatory status | FDA-approved for type 2 diabetes and for cardiovascular risk reduction in type 2 diabetes. |
|---|---|
| Drug class | GLP-1 analog fused to a modified human IgG4 Fc fragment |
| Route | Subcutaneous, once weekly |
| Half-life | ~5 days |
| Evidence rating |
5/5 Very strong
Evidence rating 5 out of 5: Very strong
Multiple phase 3 randomized trials plus regulatory approval in a major market. |
| Studied in | AWARD program in type 2 diabetes; REWIND cardiovascular outcomes trial. |
How it works
GLP-1 receptor agonism. Covalent fusion to an IgG4 Fc fragment increases molecular size above the renal filtration threshold and engages FcRn recycling, extending half-life to permit weekly dosing.
Evidence base
Rated 5 of 5 — Very strong. Multiple phase 3 randomized trials plus regulatory approval in a major market.
- REWIND is the strongest primary-prevention cardiovascular evidence in the GLP-1 class.
Benefits & potential uses
Bars indicate how well each claim is supported: three = strong human evidence, two = moderate, one = preliminary or preclinical.
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Cardiovascular benefit in primary prevention Strong evidence
REWIND is distinctive: most participants had no established cardiovascular disease at baseline, and benefit was still demonstrated.
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Reliable glycemic control Strong evidence
HbA1c reductions of roughly 1.4–1.6 percentage points across the AWARD trials.
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Simple delivery device Moderate evidence
A hidden-needle autoinjector with no dose dialling or priming, which measurably improves adherence in less dexterous patients.
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Kidney outcome signals Moderate evidence
Exploratory REWIND analyses showed reduced progression of albuminuria.
Risks, cons & cautions
Bars indicate seriousness: three = serious or common, two = moderate, one = minor.
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Modest weight loss Moderate evidence
Around 3 kg on average — far less than semaglutide or tirzepatide. It is a glycemic drug that also reduces weight, not a weight-loss drug.
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Thyroid C-cell boxed warning Serious
Standard class contraindication for medullary thyroid carcinoma and MEN2.
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GI adverse effects Moderate evidence
Nausea, diarrhea and vomiting, most common during titration.
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Pancreatitis and gallbladder disease Serious
Class effects.
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No weight-management indication Minor
It is not approved for obesity, and prescribing it for that purpose is off-label.
Who should avoid it
- Medullary thyroid carcinoma or MEN2 history
- Pregnancy
- Prior pancreatitis (relative)
- Type 1 diabetes
If used under medical supervision, monitor
- HbA1c, weight
- Renal function during GI illness
- Concomitant insulin dosing
Interactions
Not exhaustive. Always have a pharmacist or physician review your full medication list — including supplements.
- Insulin and sulfonylureas — dose reduction usually needed
- Oral drugs sensitive to gastric emptying
Regulatory & legal status
Prescription drug.
Infographic
Where to read further
We link to live literature searches rather than a frozen citation list, so you always see current results — including anything published after our last review.
- PubMed — all published literature on Dulaglutide
- PubMed — randomized controlled trials only
- ClinicalTrials.gov — registered human trials
- DailyMed — official FDA prescribing information
Related peptides in Metabolic & Weight
Terms used on this page
- Lipidation and Fatty Acid Acylation
- Lipidation is the covalent attachment of a fatty acid to a peptide, usually at a lysine side chain, creating reversible albumin binding that dramatically extends circulating half-life.
- Terminal Half-Life
- Terminal half-life is the time taken for drug concentration to fall by half during the final, slowest phase of elimination, and it sets the dosing interval.
- Antibody (Immunoglobulin)
- An antibody is a Y-shaped immunoglobulin whose variable regions bind one epitope while its constant Fc region sets effector function, half-life and isotype-specific behaviour.
- Glucagon-Like Peptide-1 (GLP-1)
- Glucagon-like peptide-1 is an incretin hormone released by intestinal L-cells after a meal that stimulates glucose-dependent insulin secretion and suppresses appetite.
- Agonist
- An agonist is a ligand that binds a receptor and stabilises its active conformation, producing a biological response rather than merely occupying the binding site.
- Glycated Haemoglobin (HbA1c)
- Glycated haemoglobin is the fraction of haemoglobin carrying glucose attached non-enzymatically, giving a weighted average of blood glucose over the preceding two to three months.
This page is educational information, not medical advice. It cannot account for your medical history, medications, or risk factors. Do not start, stop or change any treatment based on it. Speak to a qualified healthcare professional who knows your case.