Diabetes is a condition that many people in our country are currently experiencing and that requires a lot of attention. There are various types of medications to control this. Perhaps your doctor has also told you to use an injection like a pen that is injected under the skin. Today we are talking about one such injection, 'Dulaglutide'. You may know this by the brand name Trulicity. So, let's talk about this medicine simply and in a friendly way.
What really happens with this medicine?
Simply put, this medication helps control Type 2 Diabetes. It works in several ways.
- Insulin Boost: This medication stimulates your body's natural production of insulin, a hormone that helps move sugar (glucose) from the blood into cells and turn it into energy.
- Reducing sugar production: This medicine reduces the amount of sugar your liver adds to your blood.
- Slow digestion: This medicine slows down the rate at which food is digested in your stomach. This helps control the sudden spike in blood sugar levels after eating. It also helps you feel full for longer, which can help control overeating.
In addition to these things, research has found that this medicine also helps reduce the risk of heart attack and stroke in people with type 2 diabetes.
But remember, this medicine alone is not enough. A proper diet and exercise are two very important parts of this treatment.
Things you need to tell your doctor before starting medication
Before you start taking Dulaglutide, it is important to tell your doctor about your health. Especially if you or anyone in your family has any of the following conditions:
| Situation you need to report | Why is that important? |
|---|---|
| You or someone in your family has thyroid cancer or MEN 2, a cancer of the endocrine glands. | There is a very small risk that this medication may be associated with some types of thyroid cancer, so it is essential to inform your doctor about this. |
| Having had a previous history of pancreatitis. | This medication can very rarely cause pancreatitis, so it is important to inform about previous history. |
| Kidney or liver disease. | These conditions can affect the way your body removes medication, so you may need to adjust your dose or pay special attention. |
| Eye problems (Diabetic Retinopathy). | It is important to inform your doctor because sometimes eye problems caused by diabetes can be complex. |
| Being pregnant, trying to get pregnant, or breastfeeding a child. | In such cases, it is essential to discuss the safety of this medication with your doctor and make a decision. |
| Allergies to other medications, foods, or substances. | This is important to confirm whether you are allergic to dulaglutide or anything in it. |
How is this vaccine used?
This is an injection that is injected under the skin. Usually, your doctor or nursing staff will show you how to give it correctly.
- Once a week: This vaccine should be given on the same day and time each week. For example, every Sunday morning.
- Do not prime the pen: This injection pen does not need to be primed before use. It comes ready to use.
- Rotate injection sites: Instead of using the same injection site every time, rotate the injection site. You can use areas like the stomach, thigh, or the back of the upper arm.
- Do not mix with insulin: If you are also taking insulin injections, never mix the two medications together and inject them in the same syringe. Inject the two injections separately, in two separate places.
- Used needles: Never throw used needles in the trash. They are very dangerous. They should be placed in a special sharps container that can be removed. If you don't have one, ask your doctor for one.
What to do if you miss a dose?
If you miss your scheduled dose, take it as soon as you remember. However, if your next dose is less than 3 days away (i.e., more than 4 days late), skip the missed dose and take the next dose on the scheduled day at the same time. Do not take two doses at once.
What if I take too much medicine?
If you have any suspicion that you have taken too much of this medicine, go to the nearest hospital Emergency Department (ETU) immediately. Alternatively, call the National Poisons Information Centre at the Colombo National Hospital for advice.
Things to be careful about when taking medicine
- Blood Sugar Testing: Learn how to test your blood sugar at home. Know the symptoms of hypoglycemia and hyperglycemia and how to deal with them.
- HbA1C test: Your doctor will do a blood test called HbA1C every 3 to 6 months. This measures how well your diabetes has been controlled over the past 2-3 months.
- If your blood sugar drops: Always keep some sugar (e.g. sugar cubes, glucose tablets, toffee) with you. If your blood sugar drops too low and you feel dizzy or convulsed, do not put anything in your mouth at that time. You should go to the hospital immediately.
- Vomiting or diarrhea: If you have excessive vomiting or diarrhea, or if you sweat a lot, you may be losing a lot of water from your body and becoming dehydrated. This is not good for your kidneys. Talk to your doctor at such times.
- Don't share your pen: Never share your injection pen with anyone else. Even if you share the needle, you can still spread dangerous viruses like Hepatitis and HIV.
Side effects of the medicine
Like any medicine, Dulaglutide can cause side effects in some people. Some of these are serious, while others are mild.
| Serious side effects that require immediate medical attention | |
|---|---|
| Pancreatitis | Severe stomach pain that spreads to the back, especially after eating, vomiting, and fever. |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Thyroid tumor | Feeling a lump or swelling in the neck, difficulty swallowing, change in voice. |
| Kidney problems | Decreased urine output, swelling of the ankles, hands, or feet. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Nausea and vomiting | This can happen to many people in the early stages, and often decreases over time. |
| Diarrhea | This is also a common side effect. |
| Stomach pain and loss of appetite | These may also decrease as the body adjusts to the medication. |
How to store the medicine?
This is very important. To maintain the quality of the medicine, it must be stored correctly.
- Refrigeration (best method): Store unused, new pens in the refrigerator, not in the door, but on an inside shelf at a temperature between 2 and 8 degrees Celsius. Keep them in the box they came in. Never put them in the freezer. Do not use the medicine if it is frozen.
- Room temperature: If necessary, one pen can be kept at room temperature (below 30 degrees Celsius) for up to 14 days . But do not use it after 14 days. Protect from light and excessive heat.
Do not use expired medications. Ask your doctor for advice on how to properly dispose of them.
Take-Home Message
- Dulaglutide is a once-weekly injection used to treat type 2 diabetes and reduce the risk of associated heart disease.
- Tell your doctor about all other medications you are taking and all of your medical conditions before starting the medication.
- Never share the injection pen with anyone else. Dispose of used needles safely.
- Be aware of the symptoms of low blood sugar (fainting, sweating) and serious side effects (severe stomach pain, lumps in the neck).
- It is very important to store the medicine correctly in the refrigerator.
- While taking this medication, proper diet and exercise are essential for the success of the treatment.
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