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Key pharmacological effects include: Glucose-dependent insulin secretion Enhanced pancreatic beta-cell insulin release only when blood glucose is elevated, reducing hypoglycemia risk Suppression of glucagon secretion Decreased hepatic glucose production from pancreatic alpha cells Delayed gastric emptying Slowed movement of food from the stomach to the small intestine Central appetite regulation Reduced hunger and increased satiety through hypothalamic pathways The delayed gastric emptying effect is particularly significant and represents both a therapeutic mechanism and a potential source of adverse effects

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doi: 10.1111/jcmm.13259

Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial.Lancet

Adverse effects include severe nausea, severe vomiting and severe hypoglycemia (low blood sugar levels)

1 With metformin and pioglitazone (AWARD-1) When added to metformin and pioglitazone, dulaglutide at doses of both 1.5mg and 750 microgram showed superiority to placebo and twice-daily exenatide for HbA 1c reduction at 26 weeks