Semaglutide vs Dulaglutide

Both semaglutide and dulaglutide are GLP-1 receptor agonistic medications used to treat Type 2 diabetes. GLP-1 receptor agonists reduce the blood glucose by stimulating insulin secretion and reducing glucagon secretion, both occurring in a glucose dependent manner. This provides a lower risk of hypoglycemia. They also delay gastric emptying in the early phase, also resulting in lower blood glucose levels. A secondary outcome of the gastric emptying delay may also result in the reduction in body weight.

Semaglutide is in a class of medications known as glucagon-like peptide-1, or GLP-1, receptor agonists. It mimics the GLP-1 hormone that is released in the gastrointestinal tract after eating. One role of GLP-1 is to prompt the body to produce more insulin, which reduces blood glucose, or sugar.

Dulaglutide is used in correlation with a proper diet and exercise program to control high blood sugar if you have Type 2 diabetes. Controlling the high blood sugar will help prevent kidney damage, nerve problems, blindness, loss of limbs, and sexual function problems. This medication will also lessen the risk of a major cardiovascular event, such as heart attack or stroke, if you are at an elevated risk for heart or blood vessel disease. Dulaglutide is similar to a natural hormone in your body called incretin. It works by creating insulin release in response to high blood sugar, such as after a meal, and by decreasing the amount of sugar your liver makes. Dulaglutide is not a substitute for insulin if you need insulin treatment.

Researching Semaglutide vs Dulaglutide

For their study, the researchers evaluated 1201 metformin-treated patients aged 18 years or older with Type 2 diabetes and hemoglobin A1c levels of 7% to 10.5%. The patients were randomly assigned to treatment with either 0.5 mg semagutide, 0.75 mg dulaglutide, 1.0 mg semaglutide, or 1.5 mg dulaglutide.

Results showed that the mean percentage of hemoglobin, HbA1c, was reduced by 1.5 percentage points with 0.5 mg semaglutide vs 1.1 percentage points with 0.75 mg dulaglutide, and by 1.8 percentage points with 1.0 mg semaglutide vs 1.4 percentage points with 1.5 mg dulaglutide.
In addition to that, the mean bodyweight was reduced by about 10.1 lbs. with 0.5 mg semaglutide vs 5.1 lbs. with 0.75 mg dulaglutide, and about 14.3 lbs. with 1.0 mg semaglutide vs 6.6 lbs. with 1.5 mg dulaglutide.

Gastrointestinal disorders were the most commonly reported adverse side effect and the most frequent cause of treatment discontinuation in the study. Six fatalities also occurred throughout the study, one in each semaglutide group and two in each dulaglutide group.

The researchers concluded that at low and high doses, semaglutide was superior to dulaglutide in improving both glycemic control and reducing bodyweight, enabling a significantly greater number of patients with Type 2 diabetes to achieve clinically meaningful glycemic targets and weight loss, with a similar safety profile.

Semaglutide and dulaglutide do have similar efficacy results. There is a difference when considering the precautions. The difference of diabetic retinopathy listed for semaglutide and not listed for dulaglutide might impact the clinical decision making when prescribing a medication. If you have a medical history including retinopathy this does not exclude you from using semaglutide. If you have a history of diabetic retinopathy, you should be monitored for any progression of diabetic retinopathy with the use of semaglutide.

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