The study found that Trulicity (dulaglutide), which is approved for glucose management in people with type 2 diabetes, lowered the risk for stroke, heart attack, and kidney problems in adults with type 2 diabetes. Researchers published their findings in June 2019 in the journal The Lancet and presented them at the American Diabetes Association’s (ADA’s) 79th Scientific Sessions in San Francisco. The study findings are good news for adults with type 2 diabetes, which number more than 30 million Americans in the United States, according to the Centers for Disease Control and Prevention (CDC). People with type 2 diabetes are 2 to 4 times more likely to die from heart disease compared with adults without diabetes, according to the American Heart Association. More than two-thirds of people ages 65 and older with diabetes die from heart disease and 16 percent die of stroke. “Diabetes is an extremely common problem. One in 10 adults have the disease, mostly type 2 diabetes, and 1 in 5 people over 65 have diabetes,” says lead study author Hertzel Gerstein, MD, a professor of medicine and endocrinologist of McMaster University and Hamilton Health Sciences in Hamilton, Ontario, Canada. “Diabetes is important because it about doubles the risk of cardiovascular problems in the future. Clearly, we need to identify therapies that address all of the problems related to diabetes.” Trulicity is an injection that’s used once a week. It works by helping the pancreas release the proper amount of insulin when blood sugar levels are high. The drug may also help reduce appetite and aid weight loss, according to an article published in March 2015 in the journal American Health & Drug Benefits. RELATED: What Are the Possible Complications of Type 2 Diabetes, and How Can You Help Avoid Them?

Experts in the fields of diabetes and cardiovascular care have joined forces in recent years to acknowledge and study the intersection of the two diseases and find treatments that curtail the risk of both. Earlier this year, the ADA issued the 2019 Standards of Medical Care in Diabetes, which emphasizes improving cardiovascular health and included input from the American College of Cardiology. “We’ve been focused on reducing the risk of complications from diabetes for a long time. Now, we’re getting better at doing it,” says Jennifer B. Green, MD, a professor of medicine in the Duke University division of endocrinology in Durham, North Carolina. Dr. Green was not involved in the study. “What’s different and exciting in recent years is we’re finding some of the newer medications that treat diabetes also demonstrate cardiovascular benefits, and sometimes kidney benefits, within a short period of use.” RELATED: 7 Signs Your Blood Sugar Is Out of Control

What Makes This Trial on Trulicity Different From Past Research

In Dr. Gerstein’s study, researchers looked at the impact of Trulicity, a medication known as a glucagon-like peptide 1 analogue (GLP-1) agonist, in adults with diabetes who had not yet developed cardiovascular disease. The trial, called REWIND (Researching CV Events With a Weekly Incretin in Diabetes), included 9,900 people in 24 countries. The study participants were randomized to take Trulicity or a placebo in addition to receiving standard care and were followed for more than five years to assess their overall health. While all participants had risk factors for cardiovascular disease — like extra weight, high blood pressure, and high cholesterol, per the Mayo Clinic — only 31 percent of study participants had established disease. The study showed that people taking Trulicity had a 12 percent reduction in heart attacks and strokes compared with those taking a placebo. The Trulicity group also had a 15 percent reduction in the development of kidney disease, another complication of diabetes. “It’s really exciting to me because the trial enrolled people with type 2 diabetes who were at lower risk of cardiovascular events than we’ve seen to date in other trials,” Green says. “This is the first trial that really recruited people with a broad range of underlying risks of CV (cardiovascular disease),” Gerstein says. “About 70 percent of people in the study had risk factors for heart attacks or strokes, but they had not yet had a heart attack or stroke. So the results are generalizable to large numbers of people — not just those who have already had heart attacks or strokes.” People taking Trulicity experienced modest weight loss and lower blood pressure. The most common side effects from the medication were constipation or diarrhea. “This was a long-term study — half were followed for more than five and a half years," Gerstein says. “The effects of this drug on heart disease, blood sugar and blood pressure were apparent over the length of the study. This drug has a long-term effect on cardiovascular outcomes and other outcomes, including a modest weight loss and modest lowering of blood pressure and blood sugar. That is interesting and important.” RELATED: What It’s Like to Have Uncontrolled Type 2 Diabetes

Which People With Type 2 Diabetes Should Take Trulicity?

The findings raise the question of whether more people with type 2 diabetes should take drugs, like GLP-1 agonists, that have been proven to impact cardiovascular risk and kidney disease risk. “Clearly these findings show this type of medication could benefit lots of people with diabetes,” Gerstein says. “This is pretty high-level evidence. Should more patients take it? That’s a conversation patients should have with their doctors. But this would be an important option.” Many previous studies looking at the impact of some of the new diabetes medication, such as GLP-1 agonists, were performed in patients at higher risk for heart attacks and strokes, Green noted. That doesn’t mean they don’t have use for a broader range of patients, such as those with early diabetes who do not have cardiovascular disease. “There seems to be a misunderstanding that these drugs should be reserved for people at very high risk,” Green says. “But they can be used at any time. I do hope that this study generates a lot of discussion of the value, or cost, of starting to use these newer classes of drug earlier on in the treatment algorithm.”