Introduction
Ever since Novo Nordisk invented semaglutide, people with type 2 diabetes or obesity have had a new lease on life. With its efficacy, no wonder more people sing their praises as it lowers blood sugar levels and promotes weight loss. Even before semaglutide received U.S. FDA approval, however, dulaglutide had already hit the market as Trulicity to treat type 2 diabetes.
Just like semaglutide, it mimics the hormone GLP-1 to regulate blood sugar levels. With its similar health benefits, one might wonder, ‘Is dulaglutide better than semaglutide?’
In this article, we take a closer look at semaglutide and dulaglutide. How do they work? What studies support their efficacy? And more importantly, could one be more effective than the other? Read on as we address these questions and more.
What is semaglutide?
Before we go into a comparative review of semaglutide and dulaglutide, it’s important that we first examine their respective attributes.
How semaglutide works
What is semaglutide? It belongs to a group of drugs called glucagon-like peptide-1 receptor agonists, or GLP-1 Ras. Whenever we eat and blood sugar levels are high, a hormone, GLP-1, triggers insulin release, reducing blood glucose. GLP-1 receptor agonists such as semaglutide act as GLP-1 doppelgangers, mimicking how GLP-1 triggers the release of insulin.
Another effect of taking semaglutide is that it slows down digestion or gastric emptying, making you feel fuller for longer. As a result, you don’t feel like eating as much, don’t have cravings, and end up shedding pounds.
Ozempic and Wegovy, popular brands containing semaglutide, have gained massive social media attention. While doctors often prescribe Ozempic off-label for weight loss, only Wegovy has FDA approval for obesity treatment.
Common and serious side effects
Whether you use Ozempic or Wegovy for weight management, you face the potential risk of developing its listed side effects.
The following are common and serious side effects of Ozempic and Wegovy: nausea, vomiting, diarrhea, constipation, heartburn, or abdominal pain. Healthcare providers will typically start you on small doses and work your way up to bigger doses to manage symptoms.
Ozempic and Wegovy are both administered subcutaneousely, or under the skin.
Serious side effects
Semaglutide injections’ more serious side effects include allergic reactions, hypoglycemia, pancreatitis, kidney problems, and thryroid c-cell tumors. Note, however, that these are rare.
Efficacy
Several studies have proven semaglutide’s efficacy in regulating blood sugar levels and promoting weight loss. Apart from these benefits, the drug may also play a positive role in improving cardiovascular health.
On obesity
A study published in the journal Cureus looked at the efficacy of semaglutide in treating people who were overweight. 40 percent of participants— people on once-weekly semaglutide—lost at least 15 percent of their body weight over 68 weeks. Those in the placebo group, meanwhile, lost significantly less weight.
On type 2 diabetes
Another study, published in the Journal of Pharmaceutical Technology, investigated semaglutide’s effectiveness and safety in treating type 2 diabetes. Some of the participants took semaglutide, while others took other diabetes medications. The study’s results showed that semaglutide was able to reduce blood sugar levels more successfully than other diabetes drugs.
On cardiovascular problems
Apart from type 2 diabetes, Ozempic helps reduce the risk of developing cardiovascular issues like heart attack, stroke, or death.
Wegovy, meanwhile, appears to help reduce markers of heart disease, from high cholesterol, high blood sugar levels, to hypertension.
What is Dulaglutide?
Now that we know what semaglutide is, let’s learn more about its competitor, dulaglutide. What exactly is it and how does it work?
Just like semaglutide, dulaglutide is also a GLP-1 Ra, mimicking GLP-1 with its insulin-triggering action. It is made of two modified GLP-1 peptides that have amino acid substitutions. Similar to semaglutide, it triggers the pancreas to secrete insulin and regulate blood sugar levels. It also delays gastric emptying and promotes weight loss through curbed appetites.
While the two drugs work similarly, note that they are different GLP-1 receptor agonists, with varying chemical structures. Dulaglutide is a form of biologic medication, meaning it’s derived from humans, animals, or microorganisms through the use of biotechnology.
Dulaglutide is sold under the brand name Trulicity, which directly competes with Ozempic and Wegovy. Similar to the two semaglutide brands, Trulicity comes in pre-filled injectable pen formats, marketed as an anti-diabetic drug. Pharmaceutical company Eli Lilly manufactures it. Apart from dulaglutide, Eli Lilly also sells two anti-diabetic brands: Mounjaro and Zepbound, which share the active ingredient tirzepatide.
Therapeutic uses and efficacy of dulaglutide
Many studies have proven the efficacy of dulaglutide. For instance, a study published in 2016 in the journal Scientific Reports found it was effective in reducing HbA1c levels. An HbA1c test is a blood test that shows your average blood sugar levels over two to three months.
Another study looked at dulaglutide’s efficacy versus dulaglutide and insulin glargine in treating diabetic patients and moderate-to-severe chronic kidney disease. Insulin glargine is a synthetic version of human insulin used to treat both type 1 and type 2 diabetes. The study found that dulaglutide worked better in regulating blood sugar levels than the dulaglutide-insulin glargine treatment.
What are its side effects?
Consistent with GLP-1 receptor agonists, the most common dulaglutide adverse events with dulaglutide were gastrointestinal disorders: nausea, vomiting and diarrhea.
Switching from Dulaglutide to Semaglutide
Yes, you may need to switch from semaglutide to dulaglutide or vice-versa if you are not seeing results with semaglutide. Your healthcare provider will probably test you for blood sugar, HbA1c levels, weight management goals, and your overall health.
Switching drugs may result in better blood glucose levels, lower HbA1c levels, increased weight loss, and better cardiovascular health.
Nevertheless, remember that dulaglutide’s efficacy may not be the same for every person, as other factors come into play. It is best to closely supervise your progress and response to switching medications with your physician.
Experts point out that there are only certain drugs that work best in tandem with others. Patients and healthcare providers need to constantly consider what the drugs are approved for, also, the pathways they operate in.
“One could switch between Ozempic and Trulicity—as they have the same FDA-approved indication for type 2 diabetes—or Wegovy and Saxenda, as they have the same FDA-approved indication for weight loss,” notes Kathleen Wyne, MD, PhD, an endocrinologist and clinical professor of internal medicine at The Ohio State University Wexner Medical Center. “There is no agent comparable to Mounjaro.”
Other factors to consider would be the dosage and potential side effects when switching. Patients need to check that the doses between the two different drugs are close enough not to cause adverse effects. They would also need to be comfortable switching to new administration routes, such as switching to taking the drugs subcutaneously. Generally, patients must eat moderately, watch what they eat, and stay hydrated when switching medications or increasing dosages.
Taking both Semaglutide and Dulaglutide
Is it safe to take both semaglutide and dulaglutide? No. It’s not recommended that you use the two together to treat type 2 diabetes or specific heart problems. This is because the two drugs work in the same way. Also, using both simultaneously increases your risk of developing side effects like diarrhea, nausea, and vomiting.
As with any treatment plan, patients should always consult their doctor before making any modifications.
Cost and supply issues
Cost and availability are two factors that largely affect people’s use of certain GLP-1 Ras over others. A month’s supply of Trulicity would set you back by $1,173.99&, whereas Ozempic costs $830* monthly, without insurance.
Meanwhile, semaglutide’s rival brands cost around $900 to $1,430 a month without insurance.
Ongoing shortage problem
Ongoing supply issues, as well, continue to plague semaglutide manufacturer Novo Nordisk and its competitors. Towards the latter part of 2023, there was a major shortage in Wegovy and Ozempic amid the clamor for the drugs. It is likely that the shortage problem will persist for several more years.
Novo Nordisk admitted a “short-term stock-out” of Wegovy in the US through December due to demand surpassing supply capacities.
*Note: Prices subject to change.
Conclusion
Semaglutide and dulaglutide are two drugs that are effectively helping people suffering from type 2 diabetes and obesity. Amid the massive popularity of semaglutide brands Ozempic and Wegovy comes dulaglutide, sold under the brand name Trulicity.
Dulaglutide is very similar to semaglutide as it is also a GLP-1 receptor agonist. However, its chemical structure varies slightly as dulaglutide is a form of biologic medication.
While they function similarly, a study discovered semaglutide was more effective in reducing blood sugar levels and triggering weight loss.
Due to concerns like cost and availability, some may opt to switch between medications like semaglutide and dulaglutide. Semaglutide and dulaglutide manufacturers have been plagued by an ongoing supply shortage because of massive demand for weight loss drugs. It is unlikely that it will be resolved anytime soon.
Patients must consider the administration route, dosage, and their lifestyle choices as these may affect other medicines’ efficacy. It’s best to switch between type 2 diabetes or weight loss drugs, so long as they have the same use.
As with any medicine use, it should be under the guidance of your healthcare provider.
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