GLP1-Agonists: What you Need to Know
Glucagon-like peptide-1 (GLP-1) agonists
Glucagon-like peptide-1 (GLP-1) agonists are a class of medications, which have become increasingly popular due to their ability to manage blood sugar levels and promote weight loss. These medications mimic the naturally occurring GLP-1 hormone, which is produced in the small intestine and is crucial in regulating insulin secretion, glucose homeostasis, and appetite.
GLP-1 agonists mimc the actions of your body’s GLP-1 hormone, resulting in the stimulation of insulin release from the pancreas, which lowers blood sugar. They also inhibit the secretion of glucagon, a hormone that raises blood sugar levels, and shows gastric emptying, which leads to a prolonged feeling of fullness and decreased appetite.
GLP-1 agonists are beneficial in managing type 2 diabetes by promoting insulin release and inhibiting glucagon secretion, which lowers blood sugar levels.
GLP-1 agonists are effective at promoting weight loss and treating obesity by suppressing the appetite, slowing gastric emptying, and inducing a prolonged feeling of fullness.
Research continues to show additional health benefits of GLP-1 agonists, including reducing the risk of major cardiovascular events, improving blood pressure and cholesterol leves, enhancing overall metabolic health, and potentially reducing the risk of heart failure and kidney disease.
GLP-1 agonists come in various dosage forms and strengths. Doses vary based on individual patient factors, including weight, age, and overall health. The approved dosages by the U.S. Food and Drug Administration (FDA) are as follows:
Semaglutide (Ozempic): 0.5 mg, 1 mg, or 2 mg once weekly for type 2 diabetes, and up to 2.4 mg once weekly for chronic weight management (marketed as Wegovy).
Tirzepatide (Mounjaro): up to 15 mg once weekly for type 2 diabetes, and up to 15 mg once weekly for chronic weight management (marketed as Tirzepatide).
Liraglutide (Victoza): 1.8 mg once daily for type 2 diabetes, and 3 mg once daily for chronic weight management (marketed as Saxenda).
Dulaglutide (Trulicity): 0.75 mg or 1.5 mg once weekly for type 2 diabetes.
Exenatide (Byetta): 5 mcg or 10 mcg twice daily for type 2 diabetes.
Exenatide extended-release (Bydureon BCise): 2 mg once weekly for type 2 diabetes.
According to the U.S. Food and Drug Administration (FDA), the most commonly reported side effects of these medications include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, belching, and flatulence. These gastrointestinal symptoms are often mild to moderate in severity and tend to diminish over time as the body adjusts to the medication. Our clinical experience has taught us that most patients tolerate the medications well.
GLP-1 agonists are not recommended for certain patient populations or medical conditions. The prescribing information for these medications contains a boxed warning regarding the potential risk of thyroid C-cell tumors, a rare form of thyroid cancer. GLP-1 agonists are contraindicated in individuals with a personal or family history of medullary thyroid carcinoma or those with multiple endocrine neoplasia syndrome type 2 (MEN 2), a genetic disorder that increases the risk of certain types of tumors.
Other contraindications and precautions for GLP-1 agonists include a history of severe allergic reactions to the medication or its components, acute or chronic pancreatitis, gallbladder disease or gallstones, and certain forms of diabetic retinopathy. Healthcare providers may exercise caution when prescribing these medications to individuals with kidney disease or a history of suicidal ideation or behavior.