Dulaglutide
Description
Dulaglutide is a medication used to help manage type 2 diabetes by lowering blo
od sugar levels. It belongs to a class of drugs called GLP-1 receptor agonists, which work by increasing insulin release from the pancreas when blood sugar is high, slowing down the movement of food from the stomach, and reducing sugar production by the liver. Dulaglutide is given as a once-weekly injection and helps improve blood sugar control along with diet and exercise. It may also help with weight management in some people with type 2 diabetes. Like all medications, it should be used under a doctor’s supervision, and patients should monitor for side effects such as nausea, vomiting, or low blood sugar, especially when taken with other diabetes medicines.
Uses
Contraindications
When should one not use Dulaglutide
- If you are allergic to Dulaglutide.
- If you are suffering from hypoglycemia (low blood sugar level).
Side effects
Common side effects of this drug are:
- Low blood sugar (Hypoglycaemia)
- Lightheadedness
- Dizziness
- Anxiety
- Nervousness
- Tiredness
- Feeling hungry
- Visual disturbances
- Headache
- Shaking
- Sweating
- Pale skin
- Skin rashes
Precautions and Warnings
Pregnancy
- This medicine can be used during pregnancy if your doctor recommends
- However, close monitoring of blood sugar levels is suggested as the dose requirements may change with each trimester of pregnancy.
Breast Feeding
Driving
- Dulaglutide is known to cause low blood sugar levels and these can lead to impairment in your driving ability
- Always keep sugar or a bar of chocolate in your car with you while driving
- In case you experience any of the symptoms of low blood glucose levels like dizziness, drowsiness, visual disturbances and sweating, stop driving immediately and have sugar/ juice.
Alcohol
- It is advisable not to consume alcohol when you are taking this medicine as it interferes with the way insulin works
- Consumption of alcohol may lead to an increased risk of both low blood glucose level and high blood glucose level
- Avoid excessive use of alcohol while taking insulin.
Other General Warnings
- You have recurrent low blood sugar levels
- Be very careful about symptoms of low blood sugar like sweating, anxiety, fast heartbeat, headache, intense hunger, restlessness, dizziness, irritability. If you experience these, immediately have sugar (Do not consume artificial sweeteners). Eat something as soon as possible. Do not take insulin in such a scenario. If still the symptoms persists, seek emergency medical help...
- You have frequent fever and infections
- You have diseases related to liver and kidney
- You have thyroid disorders
- You are switching to different insulin medicine brand
- You have pain, itching and swelling at the injection site, you should continuously change the site of injection
- Avoid doing heavy exercise
- You are planning to change your diet preferences
- You should always carry sugar candy with you
- You are taking insulin but not taking adequate meals, your blood glucose can drop drastically.
Mode of Action
How Does It Work?
- Insulin is crucial to allow entry of blood glucose into each cell of the body
- Inside the cell, this glucose is used as fuel
- In type 1 diabetes mellitus, the body fails to produce adequate insulin
- This leads to glucose accumulating in the blood and cause high blood glucose
- This medicine lowers blood sugars by stimulating glucose uptake by cells, tissue and muscles, especially by skeletal muscles and fat and by inhibiting glucose production by the liver.
Interactions
Interactions with other medicines
- You may have symptoms of low blood sugar if you are taking other medicines for diabetes, depression (fluoxetine), medicines for fever and pain (salicylates), ramipril, or lisinopril
- You may have high blood sugar if you are taking oral contraceptives, thiazides, steroids, thyroxine, medicines used to treat severe diarrhoea and abnormal growth of body organs like octreotide, lanreotide....
- If you are taking the medicine pioglitazone to treat diabetes, be cautious, as some cases of heart attack and heart failure have been reported
- Some medicines block your body's response to low blood sugar, so you may not experience symptoms like headache, hunger pangs, sweating, or anxiety when your blood sugar drops. This can lead to a serious fall in blood sugar. Inform your doctor if you are on medicines like Betablockers (Metoprolol, Propranolol, Atenolol), Clonidine, Guanethidine, and Reserpine....
Interactions with food items
- This medicine is to be taken 15 mins before meals or after meals
- Maintaining a constant meal pattern is advisable when you are taking insulin
- Avoid skipping or delaying meals when you are taking insulin.
Dosage
Overdose
- Excess insulin will lead to low blood sugar levels, called hypoglycemia
- Symptoms like dizziness, fainting, sweating and tremors may be seen
- If you have the blood glucometer with you, test immediately and confirm
- Whether or not you test your levels, it is important to take some glucose water/juice/eat sugar or chocolates immediately and then rush to your doctor.
Missed a Dose
- Missed dose may lead to high blood sugar levels, which can cause symptoms like feeling thirsty, excessive urination, loss of appetite, drowsiness, fruity smell from breath, etc.
- If you missed any dose of medicine, take it as soon as you remember
- If it's time for your next dose, then skip the missed dose and continue with your regular dose schedule
- Do not take a double dose of medicine to compensate the missed one as taking double dose can cause a drastic fall in blood glucose which can be dangerous.
Content Details
Ravindra Ghongade
B. Pharm
Dr. Nikita Toshi
BDS (Bachelor of Dental Surgery), WHO FIDES member
Frequently Asked Questions (FAQs)
Q: What food items I should avoid, as I'm a diabetic?
- Avoid maida, white bread, noodles, corn flakes, poori, biryani, naan, fried rice, etc.
- Avoid seetaphal, mango, jack fruit, fruit salads with ice cream, fruit-based desserts
- Avoid cheese, milkshakes, ice creams
- Try to avoid pork, beef, soft drinks, sugarcane juice, sweetened health drinks and beverages.
Q: Can I stop taking Dulaglutide if I am feeling uncomfortable after taking this medicine?
Q: What other lifestyle modifications I need to consider to manage diabetes?
- Diet should include chapatis, multigrain bread, puffed rice with vegetables, sprouts, roasted grams, plain cooked daal, soups, steamed vegetables, cooked vegetables with less oil, Jamun, orange, guava, apple, watermelon, papaya, cow’s milk, curd, thin buttermilk, fish (grilled, baked or steamed), peanuts, cashew nuts and walnuts(handful)....
- Limit sugar intake
- Brisk walk daily for 30 minutes
- Exercise regularly
- Monitor your blood glucose regularly
- Take your anti-diabetic medication on time.
Q: I develop low blood sugar levels often, what could be the possible reasons?
- Risk factors for developing low blood glucose levels include taking too much insulin, not taking adequate meals or missing meals, too much alcohol consumption, fever and too much exercise
- Some medicines, when used with insulin can result in such episodes like other diabetes medicine glimepiride, medicines used for fever and pain (salicylates), ramipril, etc.
- Report to your doctor about these episodes. You may need a dose of adjustment.