Can Trulicity be used with insulin?

• Yes, Trulicity can be used with insulin.
• The dosage of insulin may need to be reduced.
• The combination of Trulicity and insulin increases the risk of low blood sugar levels (hypoglycemia).
• Trulicity is only suitable for people with type 2 diabetes who still have functioning insulin-producing cells in their pancreas.
• Trulicity is given by subcutaneous injection, once a week. The injection site for Trulicity and insulin should be spaced apart.

Trulicity (dulaglutide) mimics the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. It may be used for the treatment of type 2 diabetes in adults over the age of 18, or to reduce the risk of major adverse cardiovascular events (such as a heart attack or stroke) occurring in adults with type 2 diabetes who already have cardiovascular disease or are at high risk of cardiovascular disease.

Insulin is a hormone that is produced naturally in our bodies. There are several different types of insulin and each one has been made to last for a specific length of time. This allows doctors to prescribe a dosing schedule that better replicates the natural release of insulin by the body in response to food.

Both Trulicity and insulin are given by subcutaneous injection (just under the skin). Trulicity is given once a week, and the dosing schedule for insulin varies, depending on the person but may be given once to several times per day. Some people use an insulin pump, which injects insulin continuously.

Avoid injecting Trulicity into the same area of skin that you have previously injected insulin. Try to ensure at least 4 to 6 inches (10 to 15cm) of skin is between the two sites. Do not use a site where the skin is discolored, bruised, broken, covered with a psoriatic lesion, or has a rash. You can inject into the skin on your thigh, stomach area (except for a 2 inch [5cm]) area around your belly button, or the outer area of your upper arm.

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How does Trulicity work?

Trulicity mimics the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels.

Trulicity contains 90% of the same amino acid sequence as naturally occurring GLP-1. This enables it to bind to and activate GLP-1 receptors, which stimulates insulin secretion and lowers glucagon secretion when blood glucose levels are high. It also causes a slowing down in how fast the stomach empties.

Trulicity is given by subcutaneous (under the skin) injection into your stomach, thighs, or upper arm, once a week and may be used for the treatment of type 2 diabetes. Trulicity does not work for type 1 diabetes.

Trulicity is not a form of insulin. It relies on people still having some functioning beta cells – these are cells in the pancreas that produce, store, and release insulin.

Trulicity belongs to the class of medicines known as GLP-1 receptor agonists. It may also be called an incretin mimetic.

How does insulin work?

Insulin is produced, stored, and released by beta cells in the pancreas. People with type 1 diabetes have very few functioning beta cells. The beta cells in people with type 2 diabetes usually retain some function, at least initially, but as their diabetes progresses, their ability to produce insulin decreases.

The main role of insulin is to allow cells throughout the body to uptake glucose (sugar) and convert it into a form that can be used by these cells for energy. Without insulin, we cannot survive, and death from diabetes was a common occurrence until insulin was discovered in the early 1900s by Frederick Banting and Charles Best.