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Peptide fusion protein drug (FDA approved)Human trialsFDA approved

Dulaglutide

Dulaglutide

Last reviewed October 27, 2026 · 16 sources · Written for general readers · Compare with another compound →

The bottom line

Dulaglutide is an FDA approved weekly GLP-1 shot sold as Trulicity. It lowers blood sugar in type 2 diabetes and cut heart attack, stroke or heart death by about 12% in a large trial. Weight loss is modest, usually 1 to 5 kg, and it is not approved for weight loss.

Where the evidence stands

What it is

Dulaglutide is a large fusion protein sold as Trulicity by Eli Lilly. It has two matching chains, each made of a GLP-1 like piece about 90% the same as the human hormone, joined to a piece of a human antibody (an IgG4 Fc fragment).[1]

It is made in Chinese hamster ovary cells and weighs about 63 kilodaltons, much larger than a typical peptide, so no simple chemical formula is listed here.[1] FDA's substance registry lists its CAS number as 923950-08-7.[2]

Trulicity is approved, with diet and exercise, to improve blood sugar control in adults and children 10 and older with type 2 diabetes. It is also approved to lower the risk of heart attack, stroke and heart death in adults with type 2 diabetes who have heart disease or several heart risk factors. Weight loss is not an approved use.[1]

Name
Dulaglutide (Dulaglutide)
Other names
Trulicity
Type
Peptide fusion protein drug (FDA approved)
CAS number
923950-08-7
Molecular weight
About 63,000 g/mol (protein)

What it does in the body

Dulaglutide is a large lab made protein: two GLP-1 like pieces joined to part of a human antibody, which keeps it in the blood for about 5 days.[1] Like the body's own GLP-1 hormone, it switches on the GLP-1 receptor, with its best known effects on the pancreas and the stomach.[1]

This is the biology, area by area. A change measured in the body, like a higher blood level, does not always mean a person feels a benefit. The claims check below covers that.

Blood sugar

Well established

On insulin making cells it raises a signaling molecule called cyclic AMP, which boosts insulin release only when sugar is high. In people with type 2 diabetes, both the quick first burst and the slower second wave of insulin release went up, and fasting glucagon went down.[1]

Gut

Well established

It slows how fast food leaves the stomach, and the slowing is larger at higher strengths, according to the FDA label.[1] Nausea affected up to about 21% of people versus about 5% on placebo.[1]

Fat and appetite

Measured in people

Weight loss is modest: in diabetes trials, weight changed from a 0.2 kg gain to a 4.6 kg loss.[1] In 255 smokers trying to quit, people on dulaglutide lost about 1 kg over 12 weeks while those on placebo gained 1.9 kg, so it prevented the usual weight gain after quitting.[3]

Heart and blood vessels

Measured in people

In REWIND, 9,901 adults with type 2 diabetes had heart attack, stroke or heart death in 12.0% on dulaglutide versus 13.4% on placebo over a median of 5.4 years.[4] Heart rate rose 2 to 4 beats per minute on average, and a fast heart rhythm was reported in 5.6% versus 3.0% on placebo.[1]

Kidneys

Measured in people

In an extra analysis of REWIND, a combined kidney outcome happened in 17.1% versus 19.6% on placebo, mostly because fewer people developed protein in the urine.[5]

Brain and behavior

Measured in people

In REWIND, the rate of a large drop on memory and thinking tests was about 14% lower after adjusting for starting scores, though the unadjusted result was not significant.[6] In 151 people in a smoking trial, those on dulaglutide drank about 29% less alcohol than those on placebo.[7] In 34 people with primary polydipsia (compulsive water drinking), it cut fluid intake about 17% and lowered thirst.[8]

Immune system

Measured in people

In adult trials of 24 to 104 weeks, 1.6% of people made antibodies against dulaglutide and 0.9% made antibodies that could block it.[1]

How it works

Dulaglutide switches on the GLP-1 receptor, the target of the body's own GLP-1 hormone.[1]

  • It raises insulin release from the pancreas when blood sugar is high.[1]
  • It lowers glucagon, a hormone that raises blood sugar, and slows how fast the stomach empties.[1]
  • Its antibody piece makes it large and slow to clear, so half of a dose is still in the body about 5 days later.[1]

The receptor action is well established and described in the FDA label.

What the research shows

We keep animal and human evidence apart. A result in animals is a reason to study something in people, not proof that it works in people.

Animal and lab studies

Rat studies are the basis for the thyroid warning

  • In a two year rat study, dulaglutide raised thyroid C cell tumors in a way that grew with dose and time, at exposures at least 3 times those in people.[1]
  • A six month study in specially bred mice and a 12 month monkey study found no increase in thyroid C cell changes.[1]
  • In diabetic rats given the drug for three months, parts of the pancreas shrank and some became inflamed at higher exposures, while monkeys at nearly 200 times human exposure showed no pancreas inflammation.[1]
  • In pregnant rats and rabbits, exposures several times higher than in people caused fetal deaths, slower growth and birth defects.[1]

Limit: Whether the rat findings apply to people is unknown.[1]

Human studies

Large trials, including heart and kidney outcomes

  • Diabetes trials: in seven trials of 24 to 52 weeks with 299 to 1,842 adults each, HbA1c fell about 0.7 to 1.8 points. Weight fell up to 4.6 kg, while insulin glargine led to a 1.4 kg gain in one trial.[1]
  • Higher strengths (AWARD-11): 1,842 adults also taking metformin were treated for 52 weeks. At 36 weeks, HbA1c fell about 1.5 to 1.8 points and weight 3.0 to 4.6 kg, rising with strength. Nausea rose from 13.4% to 16.4% and vomiting from 5.6% to 9.3% as strength went up.[1][10]
  • REWIND: 9,901 adults with type 2 diabetes, only about 31.5% with known heart disease, were followed for a median of 5.4 years. Heart events were 12.0% versus 13.4% on placebo.[4][1]
  • REWIND kidney analysis: a combined kidney outcome was about 15% less likely on dulaglutide, driven mainly by less protein in the urine.[5]
  • REWIND memory and thinking: among 8,828 adults with test scores over a median of 5.4 years, a large drop in scores was about 14% less likely on dulaglutide after adjustment, but not significantly different before adjustment.[6] Blood markers of brain damage did not change overall.[12]
  • Smoking trial: 255 adult smokers got weekly dulaglutide or placebo plus standard quit aids for 12 weeks. Quit rates did not differ (63% versus 65%), but the dulaglutide group lost about 1 kg while the placebo group gained 1.9 kg. Gut symptoms were more common on dulaglutide than on placebo. Among 151 drinkers, alcohol intake was 29% lower.[3][7]
  • Youths with type 2 diabetes: 154 people aged 10 to 17 were treated for 26 weeks. HbA1c fell up to 0.9 points versus a 0.6 point rise on placebo, with no difference in BMI.[11]
  • Compared with mazdutide: in a 28 week trial of 731 Chinese adults, dulaglutide led to about 2.8% weight loss, less than mazdutide.[9][13]
  • Side effects: in placebo controlled studies, nausea affected up to about 21% versus about 5% on placebo, and diarrhea and vomiting each up to about 13%. In REWIND, gut side effects were reported by 47.4% versus 34.1%.[1][4]
  • Quitting: stomach side effects led up to 3.5% of people to stop, versus 0.2% on placebo.[1]

Limit: The trials were in people with type 2 diabetes, so they do not show how well it works for weight loss in people without diabetes.

Claims check

The most common claims about this compound, and what studies actually found. Verdicts rate the evidence, not whether you should use it.

Lowers blood sugar

Shown in people

In trials of 24 to 52 weeks in adults with type 2 diabetes, HbA1c (a three month blood sugar average) fell about 0.7 to 1.8 points, more than with sitagliptin, exenatide or insulin glargine in head to head trials.[1]

Protects the heart

Shown in people

REWIND followed 9,901 adults aged 50 and older with type 2 diabetes for a median of 5.4 years. Heart attack, stroke or heart death happened in 12.0% on dulaglutide versus 13.4% on placebo, about 12% lower risk. Deaths from any cause were not clearly different.[4]

Protects the kidneys

Mixed results

In an extra analysis of REWIND, a combined kidney outcome happened in 17.1% versus 19.6% on placebo. The difference came mostly from less protein in the urine; the drops in kidney filtering and the need for dialysis were not clearly different.[5]

Causes weight loss

Mixed results

In diabetes trials, weight change ranged from a 0.2 kg gain to a 4.6 kg loss, with more loss at higher strengths.[1] In a 28 week trial of 731 adults with type 2 diabetes, people on mazdutide lost about 4 to 6 percentage points more weight than on dulaglutide.[9] It has not been tested as a weight loss drug in people without diabetes.[1] Even at the highest strength in AWARD-11, people lost about 4.6 kg on average over 36 weeks.[10]

Helps teens with type 2 diabetes

Shown in people

In a 26 week trial of 154 youths aged 10 to 17, HbA1c fell 0.6 to 0.9 points on dulaglutide and rose 0.6 on placebo. About 51% reached an HbA1c under 7% versus 14%. BMI did not change differently between groups.[11]

Protects memory and thinking

Mixed results

In REWIND, 8,828 adults with cognitive tests were followed for a median of 5.4 years. The unadjusted risk of a large drop in test scores was not significantly lower (rates 4.05 versus 4.35 per 100 person years), but after adjusting for starting scores it was about 14% lower.[6] A 2026 reanalysis of blood markers of brain damage in 7,368 people found no overall change, with benefits only in people who started with high levels.[12]

Reduces alcohol drinking

Mixed results

In a 12 week trial in smokers, a planned secondary analysis of 151 people who drank found that those on dulaglutide drank 29% less alcohol than those on placebo.[7] The trial was built to test smoking, where it did not help: 63% quit on dulaglutide versus 65% on placebo.[3]

Known risks and side effects

  • Stomach and gut side effects. Nausea affected up to 21% versus 5% on placebo, vomiting up to 13% versus 2%, diarrhea up to 13% versus 7%, and loss of appetite up to 9% versus 2%. Fluid loss from vomiting or diarrhea can lead to kidney injury.[1]
  • Boxed warning for thyroid tumors. People with a personal or family history of medullary thyroid cancer or MEN 2 (an inherited tumor syndrome) should not use it. The warning is based on rat studies.[1]
  • Pancreas and gallbladder. The label warns about pancreatitis (an inflamed pancreas) and gallbladder disease.[1]
  • Eye problems in people with diabetic eye disease. People with a history of diabetic retinopathy (eye damage from diabetes) may see it get worse.[1]
  • Low blood sugar with other diabetes drugs. Low blood sugar was common when it was added to insulin, reaching about 69% to 77% with mealtime insulin, and about 20% with sulfonylurea pills.[1]

Regulatory status

Today: Trulicity has been FDA approved since September 2014 under a biologics license, and its label was last revised in March 2026. It is not approved for weight loss.[14][15] WADA's 2026 Prohibited List does not name GLP-1 drugs.[16]

  1. FDA approved Trulicity for blood sugar control in adults with type 2 diabetes.[14]
  2. FDA records list approval of a new indication for Trulicity.[15]
  3. FDA records list approval of a new dosing regimen.[15]
  4. FDA records list approval for a new patient population.[15]
  5. FDA approved the latest label revision.[15]

Sources

  1. Eli Lilly and Company. TRULICITY (dulaglutide) injection: prescribing information. Revised 03/2026. FDA label
  2. U.S. Food and Drug Administration, Global Substance Registration System. Dulaglutide (UNII WTT295HSY5): codes. FDA GSRS
  3. Lengsfeld S, Burkard T, Meienberg A, et al. Effect of dulaglutide in promoting abstinence during smoking cessation: a single-centre, randomized, double-blind, placebo-controlled, parallel group trial. EClinicalMedicine. 2023;57:101865. PMID 36874396
  4. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394(10193):121-130. PMID 31189511
  5. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet. 2019. PMID 31189509
  6. Cukierman-Yaffe T, Gerstein HC, Colhoun HM, et al. Effect of dulaglutide on cognitive impairment in type 2 diabetes: an exploratory analysis of the REWIND trial. Lancet Neurol. 2020;19(7):582-590. PMID 32562683
  7. Probst L, Monnerat S, Vogt DR, et al. Effects of dulaglutide on alcohol consumption during smoking cessation. JCI Insight. 2023;8(22):e170419. PMID 37991022
  8. Winzeler B, Sailer CO, Coynel D, et al. A randomized controlled trial of the GLP-1 receptor agonist dulaglutide in primary polydipsia. J Clin Invest. 2021;131(20):e151800. PMID 34473645
  9. Guo L, Zhang B, Xue X, et al. Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes. Nature. 2026;652(8108):181-188. doi:10.1038/s41586-025-10031-z
  10. Frias JP, Bonora E, Nevarez Ruiz L, et al. Efficacy and Safety of Dulaglutide 3.0 mg and 4.5 mg Versus Dulaglutide 1.5 mg in Metformin-Treated Patients With Type 2 Diabetes in a Randomized Controlled Trial (AWARD-11). Diabetes Care. 2021;44(3):765-773. PMID 33397768
  11. Arslanian SA, Hannon T, Zeitler P, et al. Once-Weekly Dulaglutide for the Treatment of Youths with Type 2 Diabetes. N Engl J Med. 2022. PMID 35658022
  12. Wilson JM, Dage JL, Qian HR, et al. Dulaglutide and neurodegeneration biomarkers: REWIND post hoc analysis. Alzheimers Dement. 2026;22(4):e71391. PMID 41988866
  13. Innovent Biologics. Press release on publication of the DREAMS-1 and DREAMS-2 phase 3 mazdutide results in Nature. December 17, 2025 (reposted by BioSpace). Company press release
  14. U.S. Food and Drug Administration. Approval letter, BLA 125469, Trulicity (dulaglutide). September 18, 2014. FDA approval letter
  15. U.S. Food and Drug Administration. Drugs@FDA: BLA 125469, Trulicity (dulaglutide). Drugs@FDA
  16. World Anti-Doping Agency. World Anti-Doping Code International Standard: Prohibited List 2026. September 2025. WADA Prohibited List 2026
Medical disclaimer

This page is educational information only. It is not medical advice and does not replace care from a licensed medical provider. Do not use this page to decide whether to take any substance. Talk to a licensed medical provider first.

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