This commentary summarises recent updates to diabetes management guidelines regarding the use of glucagon-like peptide 1 receptor agonists such as dulaglutide, both as a second-line agent and as a first-line injectable agent in type 2 diabetes. It also provides practical guidance on the use of dulaglutide as an alternative to basal insulin or in combination with insulin by examining the AWARD (Assessment of Weekly AdministRation of LY2189265 [dulaglutide] in Diabetes) studies.

The AWARD studies demonstrate that dulaglutide provides effective glucose lowering together with sustained weight loss and a low incidence of hypoglycaemia when used as the first injectable option and when used in combination with titrated basal insulin or prandial insulin.

The broad range of patients enrolled in the AWARD studies reflect the heterogeneity of the general population of patients with type 2 diabetes, and demonstrate that dulaglutide is a valid treatment option across a wide range of patient characteristics, including different levels of hyperglycaemia, glycaemic patterns, prior oral antidiabetic therapies, age and duration of diabetes, and presence of comorbidities.

Most patients enrolled in AWARD-9 reported that the standard dulaglutide injection device used in the study and in clinical practice was “easy” or “very easy”, and 90% were satisfied with the overall injection experience.