SugarMD - Trulicity Review: RISKS & SIDE EFFECTS [2020 Doctor review]

Short Summary

Main recommendation: Trulicity (dulaglutide), a GLP-1 class medication, may be worth trying for type 2 diabetes when insurance covers it or a patient cannot tolerate other options, though Ozempic and Rybelsus are described as the better-performing choices in this class. The speaker, a diabetes doctor who says he does not work for Trulicity, stresses that side effects are often temporary, that weight loss is common, and that cost depends heavily on insurance.

Key Points

• Trulicity works by boosting gastrointestinal hormones so the body releases insulin in response to food, and it suppresses glucagon, which helps prevent blood sugar spikes after meals.
• Unlike sulfonylureas such as glipizide, glyburide, and glimepiride, which can cause low blood sugar and push appetite up, Trulicity tends to reduce appetite and slow stomach emptying, which often leads to weight loss.
• Common side effects include nausea, diarrhea, and constipation; the speaker says these usually fade within a couple of weeks.
• The speaker ranks Ozempic and Rybelsus as the strongest GLP-1 options for efficacy and weight loss, with Trulicity doing a fair job by comparison.
• Cost varies widely: the speaker says the medication can cost around a thousand dollars or more without insurance coverage, and a three-month supply may run a couple thousand dollars if not covered.
• Black box warnings reference rat studies showing pancreatic and medullary thyroid cancer; the speaker says these effects have not been confirmed in humans, but he advises caution with a family history of either cancer or a history of pancreatitis.

Details Worth Noting

• Concrete instructions: The speaker suggests checking whether insurance covers Trulicity or other GLP-1 options before starting, and comparing out-of-pocket costs; if the cost difference is small and you prefer it, choosing the one you can use more easily.
• Concrete instructions: Keep unused pens refrigerated right away. Trulicity has a shelf life of only two weeks outside the refrigerator, whereas Ozempic lasts eight weeks, so a mailed three-month supply can be wasted if not refrigerated.
• Concrete instructions: To inject, turn the knob from red to green, remove the cap, place the pen against the abdomen or thigh, press the button, and hold for 10 seconds. The pen is disposable and is thrown away after one use.
• Concrete instructions: Tell your doctor about any family history of medullary thyroid cancer or pancreatic cancer, and about any history of pancreatitis, since the speaker says these warrant caution or an alternative medication.
• Trulicity hides its needle, which the speaker says may help people who are uncomfortable seeing needles, though its needle is larger than those of Ozempic or Victoza.
• The speaker argues that the needles used with these medications are small enough that the injection hurts about as much as a finger stick.

Bottom Line

Trulicity is a reasonable GLP-1 option, especially if it is the covered or easier-to-use choice, but its shelf-life limits, cost dependence on insurance, and side-effect profile mean it should be weighed against alternatives like Ozempic with a doctor.