Trulicity represents an expensive add-on treatment to assist in controlling type 2 diabetes.  Only one shot of Trulicity every 7 days is standard in addition to routine diabetes therapy.  The cost for one month of Trulicity for a cash paying patient averages about $800.

A battle is brewing between Trulicity and a closely related competitor – Victoza.  Both activate the GLP-1 receptor which leads to greater insulin release and decrease in a hormone, glucagon, that counteracts the action of insulin.  In the process emptying of the stomach is slowed which results in reduced appetite and then the possibility of weight loss.

Side effects tend to be mild but relatively common.  Among the most frequent are nausea in up to 20%, vomiting in 10%, diarrhea in 10% and abdominal pain in 8%.  Overall gastrointestinal complaints occur in at least 1 in 3 individuals taking Trulicity.

Less common but more important adverse reactions include inflammation of the pancreas or pancreatitis, kidney problems especially in dehydrated individuals and at least in animals the possibility of thyroid tumors.  Low blood sugar or hypoglycemia rarely occurs with Trulicity itself but may develop when the drug is combined with other diabetes therapies.

In order to boost sales in an increasingly cost conscious environment, the manufacturer entered into an agreement with Harvard Pilgrim Health Care.  Eli Lilly, the manufacturer and one of the behemoths of the drug industry, promised to pay the insurance company a larger than customary rebate if Trulicity failed to perform better than competing drugs in the same family.

But the real issue involves individual responsibility.  Most type 2 diabetics weigh too much.  Diet coupled with exercise almost certainly either eliminates the disease or makes it much easier to treat.  Only a failure to adhere to these simple, obvious but admittedly difficult lifestyle changes allows the incidence of diabetes to continue spiralling out of control.  Irrespective of choice of medication, complications of diabetes accumulate over the years and result in hypertension, heart disease, stroke, kidney failure, diminished vision and nerve damage.  Proper diet and weight loss appears to prevent many of these complications.

Your choice, McDonald’s or a salad.

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