Describe The Role Of Trulicity In The Management Of Type 2 Diabetes: Case Study

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Date and time requested: January 21, 2015 at 11:30 AM
Date and time answered: February 28, 2015 at 3:00 PM
Describe the role of Trulicity in the management of type 2 DM. What does the evidence show and its place in therapy?

Background In the United States, approximately 25.8 million people have diabetes. Of the 25.8 million people, about 5% to 10% have type 1 diabetes and 90% to 95% have type 2 diabetes (T2DM).1 The prevalence of diabetes is much higher in non-Hispanic white, American Indian and African American and lower in Hispanic and Asian.1 Majority of the worldwide diabetic patients are type 2 diabetes which means they are insulin resistant. Insulin is important in lowering blood glucose by bringing in glucose inside the cells. If their
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It is a long acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) that is administered once weekly by subcutaneous injection.3 Dulaglutide acts like endogenous GLP-1 incretin hormone, resulting in an increase of insulin secretion, decrease in glucagon, and increase fullness to decrease blood glucose and promote weight loss.3 Its current place in therapy is used as second and third line, with Metformin as first line. A few clinical trials were conducted to compare the safety and efficacy of dulaglutide used as a monotherapy and combination therapy to other antidiabetic …show more content…
In another study, dulaglutide in addition to metformin of more than 1500mg/day resulted in more side effects and hypoglycemia, but all treatments decreased blood pressure compared to treatment with sitagliptin (DDP-4 inhibitor) 100 mg per day.3 In addition to pioglitazone and metformin, patients who received dulaglutide 0.75 mg or 1.5 mg had a slight reduction in A1c level and FPG, but had similar adverse drug events.3 Lastly, compared to liraglutide which is also a GLP-1 RA, there was no significant difference in lowering FPG or postprandial glucose in the 599 T2DM patients with diabetes for 7.2 years and A1c

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