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The development of MS is closely related to innate immune cells, namely macrophages, microglia, and NK cells, as well as adaptive immune cells like T lymphocytes [259]

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Trulicity's cardiovascular protection appears to operate through additional mechanisms beyond glycemic control including anti-inflammatory effects, improved blood vessel function, and reductions in blood pressure and triglycerides though the full picture of how dulaglutide reduces cardiovascular events is still being studied

Conversely, some individuals experience diarrhoea, which may be related to diabetic autonomic neuropathy, dietary factors, or medications such as metformin