From the Guidelines
Both Trulicity (dulaglutide) and Ozempic (semaglutide) are effective GLP-1 receptor agonists for treating type 2 diabetes and weight management, but Ozempic generally produces greater weight loss and A1C reduction, as supported by the most recent evidence 1.
Key Differences
- Trulicity is administered once weekly at doses of 0.75mg, 1.5mg, 3mg, or 4.5mg, while Ozempic is also weekly at 0.25mg, 0.5mg, 1mg, or 2mg.
- Both medications work by mimicking the GLP-1 hormone to increase insulin secretion, decrease glucagon, slow gastric emptying, and reduce appetite.
- Side effects for both include nausea, vomiting, and diarrhea, which typically improve over time.
- Ozempic may cause slightly more gastrointestinal side effects but offers greater efficacy, as suggested by studies comparing GLP-1 receptor agonists 1.
Considerations for Choice
- Insurance coverage varies significantly between these medications, which may influence your choice.
- Both require refrigeration before first use and are administered via pre-filled injection pens.
- Your specific health goals, tolerance to side effects, and insurance coverage should guide your decision between these similar but distinct treatment options.
Evidence Summary
- The most recent guidelines and studies suggest that GLP-1 receptor agonists, including dulaglutide and semaglutide, reduce the risk of major adverse cardiovascular events and have benefits for weight management and glycemic control 1.
- Semaglutide has been shown to have a greater effect on weight loss and A1C reduction compared to other GLP-1 receptor agonists, including dulaglutide 1.
From the Research
Comparison of Dulaglutide and Semaglutide
- Both dulaglutide (Trulicity) and semaglutide (Ozempic) are glucagon-like peptide-1 (GLP-1) receptor agonists used for the treatment of type 2 diabetes mellitus (T2DM) 2, 3.
- Dulaglutide is administered subcutaneously once weekly, while semaglutide is available in both subcutaneous and oral dosage forms 2, 3.
- Both medications have been shown to improve glycemic control, promote weight loss, and have a low risk of hypoglycemia 2, 4, 3.
- Semaglutide has been proven to have cardiovascular benefits, reducing the risk of major adverse cardiovascular events, cardiovascular death, and all-cause mortality 5, 6.
- A network meta-analysis found that oral semaglutide was statistically better than dulaglutide in reducing cardiovascular death events, with a significant reduction in risk (OR 0.46,95% CI 0.20-0.97) 5.
- The ranking results showed that oral semaglutide had the highest probability to be ranked first in reducing cardiovascular death and death from any cause, while once weekly semaglutide had the highest probability to be ranked first in reducing myocardial infarction and stroke events 5.
- Both dulaglutide and semaglutide are generally well-tolerated, with gastrointestinal adverse effects being the most frequently reported 2, 4, 3.
- The choice between dulaglutide and semaglutide may depend on individual patient factors, such as renal or hepatic function, and the presence of established cardiovascular disease or risk factors 3, 5, 6.