This was patented by Novo Nordisk in 1996 and the first paper on it was published in 2000 (Knudsen, Nielsen, Huusfeldt)
As a long-acting GLP-1 analog, Trulicity is bound to albumin, giving it an extended half-life of approximately 5 days that maintains steady-state insulin secretion throughout the week
Peptide degradation is real, measurable, and irreversible
While side effects are often cited as a reason for GLP-1 non-adherence, the gap in persistence for the same molecule reflects deeper behavioral and systemic challenges
Normally, patients fast before surgery to reduce this risk, but GLP-1 medications can cause food to remain in the stomach longer than expected, increasing the chance of aspiration even after fasting
Not everybody responds at the same rate