GLP-1 agonists

What is GLP-1 & Does it Affect Weight & Cognition?

Some scientists hypothesize that GLP-1 decreases appetite by acting on specific areas in the brain. One side effect of GLP-1 agonists is weight loss, which is usually desired in patients with type 2 diabetes. However, GLP-1’s effects on weight haven’t been properly verified in humans without diabetes.

Effects of GLP-1 on appetite and weight

GLP-1 in both physiologic and pharmacologic doses promotes satiety, affects mechanistic properties of the GI tract and results in negative energy balance. Additionally, its success in promoting weight loss makes GLP-1 agonist therapy an attractive option in the management of type 2 diabetes. What needs to be balanced against this is the reported association between GLP-1 receptor agonist therapy and pancreatitis, pancreatic hyperplasia and pancreatic neoplasia [71].

GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus

Adverse effects of GLP-1 receptor agonists include nausea, vomiting and diarrhoea, injection-site reactions, antibody formation and increased heart rate

GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects

Glucagon like peptide-1 (GLP-1) is a 30 or 31 amino acid long peptide hormone mainly secreted by 3 tissues in the human body: enteroendocrine L cells in the distal intestine, alpha cells in the pancreas, and the central nervous system. Through its interaction with the GLP-1 receptor (GLP-1R), GLP-1 participates in the regulation of glucose homeostasis. In addition, glucagon like peptide-1 receptor agonists (GLP-1RAs) can be combined with GLP-1Rs, playing the same role as GLP-1.

Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes

Administration of GLP-1 receptor agonists stimulates GLP-1 receptors, thereby increasing insulin secretion in response to oral and intravenous glucose to similar extents; this means the magnitude of the incretin effect should remain unchanged

Incretin Mimetics (GLP-1 Agonists)

The drugs, also commonly known as glucagon-like peptide 1 (GLP-1) receptor agonists or GLP-1 analogues, are normally prescribed for patients who have not been able to control their condition with tablet medication.

The Effect of Glucagon-Like Peptide 1 Receptor Agonists on Weight Loss in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison Meta-Analysis

This review provides evidence that glucagon-like peptide-1 receptor agonist therapies are associated with weight loss in overweight or obese patients with type 2 diabetes with no difference in weight loss seen between the different types of GLP-1 receptor agonists assessed.

The therapeutic potential of GLP-1 receptor biased agonism

At present, most evidence derives from cellular and animal studies, and more human data are required to determine whether this approach represents a genuine therapeutic advance.

Non-insulin Injectable Diabetes Medications

You might be wondering why anyone would take these drugs, since they must be injected. These drugs do lower HbA1c levels, but only by 0.5% to 1.5%. They’re also only used as a second or third agent, not by themselves. One of the main draws of these drugs is that they do lead to weight loss in about 80% of users, and they seem to curb hunger, making it a good choice for people who constantly feel hungry. Weight loss eventually plateaus, however, so keep that in mind.

GLP-1 Agonists

GLP-1 agonists are used to lower blood sugar levels to treat diabetes type 2 by releasing more insulin into the bloodstream

Ozempic

Ozempic® is a medicine for adults with type 2 diabetes that, along with diet and exercise, may improve blood sugar. While not for weight loss, Ozempic® may help you lose some weight.

Rybelsus

Though not for weight loss, RYBELSUS® may help you lose some weight

Wegovy

Wegovy® is for adults with obesity (BMI ≥30) or overweight (excess weight) (BMI ≥27) who also have weight-related medical problems to help them lose weight and keep it off. Wegovy® should be used with a reduced-calorie meal plan and increased physical activity.

StatPearls

Many formulations of GLP-1 agonists, all of which historically were injectable and administered subcutaneously due to poor oral bioavailability, can be prescribed in the United States. Lixisenatide and liraglutide dosing are once-daily, albiglutide, dulaglutide, semaglutide dosing is once weekly, and exenatide can be dosed either as a twice-daily or a once-weekly injection. Recently, the FDA approved an oral formulation of semaglutide.