Can a patient with type 1 diabetes mellitus be treated with Trulicity (dulaglutide)?

From the Guidelines

A type 1 diabetic can be considered for Trulicity (dulaglutide) as an adjunct therapy to insulin, although it is not FDA-approved specifically for Type 1 diabetes, and the decision should be made on a case-by-case basis with careful consideration of the potential benefits and risks. When considering the use of Trulicity in Type 1 diabetes, it's essential to look at the available evidence on GLP-1 receptor agonists, which have shown small reductions in A1C and body weight in people with Type 1 diabetes 1. The typical starting dose of Trulicity is 0.75 mg injected subcutaneously once weekly, which may be increased to 1.5 mg weekly if needed. For Type 1 diabetics, Trulicity would not replace insulin therapy but would be used in addition to it, and patients should be aware that it may affect insulin dosing needs and should monitor blood glucose levels carefully, especially when first starting the medication. Some key points to consider when using Trulicity in Type 1 diabetes include:

• The potential for reduced insulin requirements due to the medication's effect on GLP-1 receptors
• The need for careful monitoring of blood glucose levels to avoid hypoglycemia when combining Trulicity with insulin
• The importance of discussing the potential benefits and risks of Trulicity with an endocrinologist to determine if it is appropriate for the individual patient's situation. It's also crucial to note that while Trulicity is not approved for Type 1 diabetes, other GLP-1 receptor agonists like liraglutide and exenatide have been studied in this context, showing small reductions in A1C and body weight 1. Ultimately, the decision to use Trulicity in a Type 1 diabetic patient should be based on the individual's specific needs and circumstances, taking into account the potential benefits and risks of the medication.

From the FDA Drug Label

TRULICITY is an injectable prescription medicine that is used: along with diet and exercise to improve blood sugar (glucose) in adults and children 10 years of age and older with type 2 diabetes mellitus. TRULICITY is not for use in people with type 1 diabetes.

Trulicity is not indicated for type 1 diabetes. The FDA drug label explicitly states that Trulicity is not for use in people with type 1 diabetes mellitus 2.

From the Research

Type 1 Diabetes and Trulicity

• Trulicity, also known as dulaglutide, is a glucagon-like peptide-1 receptor agonist that has been approved for the treatment of type 2 diabetes 3, 4.
• However, there is evidence to suggest that dulaglutide may also be effective in patients with type 1 diabetes, particularly those with absolute insulin deficiency 5.
• A study published in 2019 found that dulaglutide was effective in reducing HbA1c levels and body mass index in patients with type 1 diabetes or type 2 diabetes with absolute insulin deficiency 5.
• Another study published in 2019 reviewed the role of glucagon-like peptide 1 receptor agonists in the treatment of type 1 diabetes mellitus, including efficacy and safety evidence, and found that these agents have a unique mechanism of action in type 1 diabetes, addressing alpha cell dysfunction and thereby suppressing inappropriate glucagon secretion 6.
• While Trulicity has not been specifically approved for the treatment of type 1 diabetes, the available evidence suggests that it may be a useful adjunctive therapy for patients with type 1 diabetes who are not achieving adequate glycemic control with insulin alone 5, 6.

Efficacy and Safety

• The efficacy and safety of dulaglutide in patients with type 1 diabetes have been evaluated in several studies, including a study published in 2019 that found significant reductions in HbA1c levels and body mass index in patients with type 1 diabetes or type 2 diabetes with absolute insulin deficiency 5.
• Another study published in 2025 found that the adjunctive use of a GLP-1 receptor agonist (semaglutide) in type 1 diabetes showed potential for improving glycemic stability and metabolic parameters without increasing hypoglycemia risk 7.
• The safety profile of dulaglutide in patients with type 1 diabetes is similar to that in patients with type 2 diabetes, with gastrointestinal symptoms being the most common adverse events 5, 3, 4.

Potential Benefits

• The use of Trulicity in patients with type 1 diabetes may offer several potential benefits, including improved glycemic control, weight loss, and reduced insulin requirements 5, 6, 7.
• Additionally, the adjunctive use of a GLP-1 receptor agonist in type 1 diabetes may help to improve metabolic parameters, such as lipid profiles and blood pressure, without increasing the risk of hypoglycemia 7.