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Patients with Hepatic Impairment Dulaglutide systemic exposure decreased by 23, 33 and 21% for mild, moderate and severe hepatic impairment groups, respectively, compared to subjects with normal hepatic function, and Cmax was decreased by a similar magnitude (Figure 1) [see Use in Specific Populations (8.7)]

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The postprandial response curves for GLP-1, glucose and insulin were calculated as total area under the curve (tAUC) using the trapezoid rule

Including insulin resistance, leptin insensitivity, and downregulated GLP-1 secretion

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