From the Guidelines
No, Trulicity (dulaglutide) is not an SGLT2 inhibitor. Trulicity belongs to a different class of medications called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists). It works by mimicking the action of the naturally occurring hormone GLP-1, which helps regulate blood sugar by increasing insulin secretion when blood sugar is high, slowing gastric emptying, and reducing glucagon secretion. This is distinctly different from SGLT2 inhibitors, which work by preventing the kidneys from reabsorbing glucose back into the blood, causing excess glucose to be eliminated through urine. Examples of SGLT2 inhibitors include medications like empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana) 1. Both GLP-1 receptor agonists like Trulicity and SGLT2 inhibitors are used to treat type 2 diabetes, but they work through completely different mechanisms in the body.
Some key points to consider:
- GLP-1 receptor agonists, such as dulaglutide, have been shown to have beneficial effects on cardiovascular outcomes, including reducing the risk of major adverse cardiovascular events (MACE) and hospitalization for heart failure (hHF) 1.
- SGLT2 inhibitors, on the other hand, have been shown to have beneficial effects on cardiovascular outcomes, including reducing the risk of hHF, MACE, and cardiovascular death, as well as preventing the progression of chronic kidney disease (CKD) 1.
- The choice between a GLP-1 receptor agonist and an SGLT2 inhibitor depends on individual patient factors, such as the presence of established cardiovascular disease, heart failure, or CKD, as well as the patient's specific needs and preferences 1.
In terms of the most recent and highest quality evidence, a study published in 2025 found that SGLT2 inhibitors reduce the incidence of heart failure and improve heart failure-related outcomes, including hospitalization for heart failure and heart failure-related symptoms, in people with diabetes with preserved or reduced ejection fraction 1. This study highlights the importance of considering the individual patient's needs and preferences when choosing between a GLP-1 receptor agonist and an SGLT2 inhibitor. Overall, while Trulicity (dulaglutide) is not an SGLT2 inhibitor, it is an important medication for the treatment of type 2 diabetes, and its use should be considered in the context of the individual patient's needs and preferences.
From the FDA Drug Label
In this 24-week placebo-controlled, double-blind trial, 423 adult patients were randomized to and received TRULICITY 0.75 mg, TRULICITY 1. 5 mg, or placebo, as add-on to sodium-glucose co-transporter 2 inhibitor (SGLT2i) therapy
- Trulicity is not an SGLT2 inhibitor, it is used as an add-on to SGLT2i therapy.
- The drug label does not classify Trulicity (dulaglutide) as an SGLT2 inhibitor but rather as a medication used in conjunction with SGLT2i. 2
From the Research
Trulicity and SGLT2 Inhibitors
- Trulicity, also known as dulaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist, not an SGLT2 (sodium-glucose cotransporter 2) inhibitor 3, 4, 5, 6.
- SGLT2 inhibitors are a different class of medications used to treat type 2 diabetes, and they work by inhibiting the reabsorption of glucose in the kidneys 7.
- Dulaglutide is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes, and it has been shown to be effective in reducing hemoglobin A1c levels and body weight 3, 4, 5, 6.
Key Differences
- The mechanism of action of dulaglutide is different from that of SGLT2 inhibitors, as it stimulates insulin secretion and suppresses glucagon in a glucose-dependent manner, delays gastric emptying, and promotes satiety 3, 4, 5, 6.
- SGLT2 inhibitors, on the other hand, work by inhibiting the reabsorption of glucose in the kidneys, thereby increasing glucose excretion in the urine 7.
- The choice between dulaglutide and an SGLT2 inhibitor depends on individual patient factors and the specific characteristics of each medication 7.