For patients with type 2 diabetes, Trulicity may be an option

Trulicity Pen, as seen from the top

It clicked

Diabetes numbers continue to grow1,2

It is estimated that 29 million people in the US—or 1 in 11—have diabetes.1 Of this number, 21 million are diagnosed and 8.1 million are undiagnosed.1 Every 19 seconds, someone is diagnosed with diabetes.2

In 2012, there were 1.7 million new cases of diabetes among people ≥20 years of age. In adults, type 2 diabetes accounts for ~90 to 95% of all diagnosed cases of diabetes.1

Therapy recommendations in type 2 diabetes from American Diabetes Association3

Monotherapy + Lifestyle Management

Start with Monotherapy unless:
  • A1C is ≥ 9%, consider Dual Therapy
  • A1C is ≥ 10%, blood glucose is greater than or equal to 300 mg/dL, or patient is markedly symptomatic, consider Combination Injectable Therapy.

Metformin

Down Arrow

A1C goal not achieved after ~3 months, proceed to 2-drug combination*

Dual Therapy + Lifestyle Management

Metformin +

SulfonylureaThiazolidinedioneDPP-4 inhibitorSGLT2 inhibitorGLP-1 receptor agonistInsulin (basal)
Down Arrow

A1C goal not achieved after ~3 months, proceed to 3-drug combination*

Triple Therapy + Lifestyle Management

Metformin +

Sulfonylurea +Thiazolidinedione +DPP-4 inhibitor +SGLT2 inhibitor +GLP-1 receptor agonist +Insulin (basal) +
TZD or
DPP-4 i or
SGLT2-i or
GLP-1 RA or
Insulin
SU or
DPP-4 i or
SGLT2-i or
GLP-1 RA or
Insulin
SU or
TZD or
SGLT2-i or
Insulin
SU or
TZD or
DPP-4 i or
GLP-1 RA or
Insulin
SU or
TZD or
SGLT2-i or
Insulin
TZD or
DPP-4 i or
SGLT2-i or
GLP-1 RA
Down Arrow

If A1C goal not achieved after approximately 3 months of triple therapy and patient (1) on oral combination, move to basal insulin or GLP-1 RA; (2) on GLP-1 RA, add basal insulin; or (3) on optimally titrated basal insulin, add GLP-1 RA or mealtime insulin. Metformin therapy should be maintained, while other oral agents may be discontinued on an individual basis to avoid unnecessarily complex or costly regimens.

Combination injectable therapy

Abbreviations: DPP-4 i=DPP-4 inhibitor; GLP-1 RA=GLP-1 receptor agonist; SGLT2-i=SGLT2 inhibitor; SU=sulfonylurea; TZD=thiazolidinedione

*Order not meant to denote any specific preference—choice dependent on a variety of patient- and disease-specific factors.

†Usually a basal insulin (NPH, glargine, detemir, degludec).

The order in the chart was determined by historical availability and the route of administration, with injectables to the right; it is not meant to denote any specific preference. Potential sequences of antihyperglycemic therapy for patients with type 2 diabetes are displayed, with the usual transition moving vertically from top to bottom (although horizontal movement within therapy stages is also possible, depending on the circumstances).


Trulicity effect on fasting plasma glucose

Type 2 diabetes treatment assessment

In addition to treatment options, consideration should also be given regarding how often to assess a patient’s current treatment. The American Diabetes Association recommends assessing treatment approximately every three months.3

Indication and Important Safety Information 
WARNING: POTENTIAL RISK OF THYROID TUMORS INCLUDING THYROID CANCER

Indication and Important Safety Information 
WARNING: POTENTIAL RISK OF THYROID TUMORS INCLUDING THYROID CANCER

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