dulaglutide + thiazolidinedione

A combination therapy of **dulaglutide**, a glucagon-like peptide 1 receptor agonist (GLP-1RA), and a **thiazolidinedione** (TZD; e.g., pioglitazone or rosiglitazone), used in the management of type 2 diabetes mellitus. Dulaglutide improves glycemic control by mimicking GLP-1 to enhance insulin secretion, suppress glucagon, and delay gastric emptying; thiazolidinediones improve insulin sensitivity primarily by acting as agonists of the peroxisome proliferator-activated receptor gamma (PPARγ). This combination has demonstrated superior reductions in all-cause mortality, major adverse cardiovascular events, and cardiovascular mortality in type 2 diabetes patients compared to monotherapy or nonuse, though the risk of hypoglycemia may increase. The combination appears to offer synergistic cardiovascular and metabolic benefits, with dulaglutide potentially mitigating adverse cardiovascular effects of thiazolidinediones[1][2][3][4][5].