Treatment options for many chronic health issues are constantly being improved by modern medicine. GLP-1 receptor agonists are drugs that may help your current course of treatment for type 2 diabetes and obesity.
GLP-1s, also known as glucagon-like peptide-1 receptor agonists, are a class of drugs that are mostly used to treat type 2 diabetes, while some formulations are also authorised to treat obesity and overweight.
GLP-1 receptor agonists function by imitating the GLP-1 hormone, which is secreted by the intestines in reaction to eating and aids in the regulation of blood sugar (glucose). Usually, the body produces additional enzymes that break down GLP-1.
The hormone GLP-1 reduces appetite. The hypothalamus is the part of the brain responsible for suppressing appetite. In addition, the GLP-1 hormone influences the pancreatic release of glucagon and insulin and reduces the rate at which food exits the stomach.
By increasing your body's natural levels of GLP-1, you can enhance its effects by taking a GLP-1 receptor agonist.
While discussing the pros and cons of adding a GLP-1 receptor agonist to your treatment plan for recently diagnosed type 2 diabetes with your physician is necessary, learning more about this drug will help you decide if it's the best choice for you.
How do I determine if GLP-1s are a good option for me?
The Food and Drug Administration (FDA) has approved GLP-1 receptor agonists for use in type 2 diabetes. Additionally, they are permitted for use in cases of obesity and overweight combined with illnesses connected to obesity, such as nonalcoholic fatty liver disease or high cholesterol. (A body mass index between 25 and 30 is considered overweight). A BMI of 30 or higher is considered obese.)
GLP-1 treatment can be a possibility if you satisfy one or both of those prerequisite requirements.
Who is a good candidate for GLP-1s?
GLP-1 receptor agonists are not necessary for everyone with type 2 diabetes or obesity.
For treating type 2 diabetes, metformin—a medicine that belongs to the biguanide pharmacological class—remains the recommended option for decreasing blood sugar.
Your doctor could believe that a GLP-1 receptor agonist is not necessary if your diabetes is thought to be well controlled with conventional therapy.
However, if your blood sugar is extremely high, your doctor can also recommend a GLP-1 receptor agonist in addition to metformin.
Guidelines state Treatment for type 2 diabetes typically includes the addition of GLP-1 receptor agonists if you:
- cannot take metformin
- are finding it difficult to maintain your desired blood sugar levels for several months.
are having issues with:
- heart failure
- atherosclerosis
- chronic kidney disease
GLP-1 receptor agonists are occasionally selected for type 2 diabetes patients with comorbidities (co-occurring conditions) because of their added benefits for weight loss, the gastrointestinal tract, and the cardiovascular system, which may improve general health.
GLP-1 receptor agonists should not be taken if you:
- pregnant
- hypersensitive to GLP-1
- suffering from serious gastrointestinal disorders, such as IBD
- more susceptible to several types of thyroid cancer
GLP-1 receptor agonists might not be suitable for you if you have a history of pancreatitis, renal failure, or gallbladder disease.
What type of GLP-1 is best for me?
GLP-1 receptor agonists come in a wide variety. Even though they all function by simulating the actions of the GLP-1 hormone, each one has a distinct formulation with a range of advantages and limitations.
Based on your unique needs, the GLP-1 receptor agonist that gives the greatest advantages at the lowest risk is the one that is best for you.
The following GLP-1 receptor agonists are currently FDA-approved:
- semaglutide (Rybelsus, Ozempic, Wegovy)
- exenatide (Bydureon BCise, Byetta)
- liraglutide (Saxenda, Victoza)
- liraglutide/insulin degludec (Xultophy)
- lixisenatide (Adlyxin)
- lixisenatide/insulin glargine (Soliqua)
- dulaglutide (Trulicity)
Regarding semaglutide, the FDA has approved Ozempic for type 2 diabetes, whereas Wegovy is approved for obesity, overweight, and disorders connected to obesity.
A combination of a GLP-1 receptor agonist and gastric inhibitory polypeptide (GIP) receptor, such as tirzepatide (Mounjaro, Zepbound), which influences extra body functions connected to insulin secretion, may also be discussed by your doctor.
Your doctor's recommendation for a medicine will be based on its safety record, track record of efficacy, and ability to address additional health issues.
For example, if losing weight is crucial to managing your type 2 diabetes, your doctor might give priority to a GLP-1 receptor agonist that has been demonstrated to be very successful in helping you manage your weight.
Which type of GLP-1 is most effective for blood sugar control?
Clinical trials have demonstrated that all FDA-approved GLP-1 receptor agonists for the treatment of newly diagnosed type 2 diabetes efficiently control blood sugar levels.
Research on which is the "best" is inconsistent. According to one of the most current 2024 comprehensive reviews and meta-analyses, tirzepatide, a GIP/GLP-1 receptor agonist combo drug, was the most successful at regulating blood sugar.
Which type of GLP-1 is more effective for weight loss?
Review data from 2021 indicates that semaglutide is the best drug for weight loss; however, the 2024 meta-analysis, which was previously noted, indicated that the most effective GLP-1 receptor agonist for weight loss was CagriSema.
The combination medication CagriSema (semaglutide/cagrilintide) is not yet FDA-approved for usage in the US.
Which GLP-1 medication has the least side effects?
The most typical side effects of GLP-1 receptor agonists include nausea, vomiting, constipation, and diarrhoea, however, some people may also experience:
- headaches
- dizziness
- indigestion
- increased infections
- rapid heart rate
In contrast to semaglutide injections, which had the highest rate of GI side effects, exenatide XR (exenatide) had the lowest rate of GI side effects, per the 2021 review already cited.
What to expect when taking a GLP-1 medication
With a few exceptions, almost all GLP-1 receptor agonists are injected once or twice a week. For instance, Rybelsus is presently the only GLP-1 receptor agonist tablet approved by the FDA that can be used once daily orally, and Victoza is an injectable that is administered daily.
An injection of a GLP-1 receptor agonist that your doctor prescribes to you will probably come in a precise dosage pen. With the help of this portable gadget with a tiny needle, you can modify your dosage as prescribed by your physician.
If you're uncomfortable injecting yourself, that's acceptable. This can be completed at your physician's office, however each visit may incur a fee.
Additional resources are accessible, like instructions for injecting the medication, which are usually found on the website of the pharmaceutical manufacturer. Additionally, your doctor can demonstrate how to give you your first dose.
The formulation affects how quickly a GLP-1 receptor agonist starts to work. While some are long-acting and require weeks to reach a therapeutic level in the body, others are fast-acting and used daily.
Rebound symptoms are a potential risk after stopping a GLP-1 receptor agonist medication. You can experience the recurrence of symptoms including appetite, weight gain, and hyperglycemia (high blood sugar) while your body becomes used to the absence of GLP-1 activity.
This is why obesity and diabetes are usually treated as lifelong conditions.
Participants in the semaglutide STEP 1 clinical trial recovered up to two-thirds of their lost weight one year after the medication was stopped.
Is GLP-1 safe for weight loss?
As of right now, the only GLP-1 receptor agonists FDA-approved for the treatment of obesity are Wegovy and Zepbound. Wegovy and Zepbound have obtained FDA approval, indicating that they have fulfilled the safety and efficacy standards required to be sold to the general public.
This does not negate the safety of other GLP-1 receptor agonists for weight loss. It simply indicates that they haven't undergone the stringent testing necessary to receive a label for that particular usage.
How to talk with your doctor about GLP-1 medication
You can inquire about GLP-1 receptor agonists before waiting for your doctor to recommend them. Be open and truthful with your doctor about your desire to incorporate a GLP-1 receptor agonist into your existing treatment regimen if you believe you could be a good candidate for one.
Your doctor can assist you in making an educated choice regarding taking a GLP-1 receptor agonist when they are aware of your objectives and the difficulties you are facing.
To maximise this conversation, you might ask yourself the following questions:
- Am I a candidate for a GLP-1 receptor agonist? Why or why not?
- What are the benefits of taking a GLP-1 receptor agonist?
- What side effects should I watch for?
- Are there any special instructions or precautions?
- Would a GLP-1 medication complement my current treatment plan?
- Which GLP-1 medication would make the most sense for me?
- What types of follow-up appointments or tests are necessary for adding a GLP-1?
It can be beneficial to educate yourself as much as possible about GLP-1 receptor agonists before your consultation. You can become acquainted with jargon and identify particular GLP-1 receptor agonists that you find appealing.
Tips for taking GLP-1 medication
As with any drug, it's crucial to take GLP-1 receptor agonists consistently.
Use these suggestions to make sure you're receiving the most out of your medication:
- observe the dosage and administration guidelines provided by your physician precisely.
- if you use injections, get assistance from a medical practitioner to learn the right administration techniques.
- make sure you take the prescription at the same time every day.
- according to the instructions on the package insert, store medications properly, such as by refrigerating or storing them at room temperature.
- making lifestyle adjustments that support general health, such as obtaining quality sleep, being hydrated, etc.
- maintain contact with your physician and adhere to a routine follow-up plan.
- keep a log of your symptoms to monitor any potential drug responses or side effects.
Furthermore, the majority of GLP-1 receptor agonists are meant to be taken in conjunction with diet and exercise plans, regardless of whether you're taking them for type 2 diabetes, obesity, or both conditions.
Takeaway
Depending on the brand, GLP-1 receptor agonists are drugs that treat type 2 diabetes and obesity. They function by imitating your body's natural GLP-1 hormone, which has multiple roles in blood sugar regulation.
Not everyone who has obesity or type 2 diabetes needs or is a good candidate for a GLP-1 receptor agonist. Your doctor can go over the advantages and contraindications of this treatment with you, as well as why it might not be a good fit for you.
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