Let's learn about new medications that help with diabetes and weight loss? (GLP-1 Agonists)

You've probably heard about a new type of injection that helps with diabetes and weight loss. Maybe you've heard a friend or relative talk about it. So, this new class of drugs that many people are talking about is called GLP-1 agonists. Let's explain everything about it today, as if we were talking to a friend.

What are these GLP-1 Agonists?

Simply put, GLP-1 agonists are a class of medications that help control blood sugar levels in people with type 2 diabetes. Not only that, but some of these medications are also used to treat people with obesity.

Most of the time, this medication comes as an injection. That means you can give it to yourself using a syringe and needle. This injection should be given into the fatty layer under the skin. Specifically, you can give this injection in the abdomen, the back of the thighs, the upper part of the buttocks, and the back of the arms.

This class of drugs is known by several other names. You don't need to know all of them, but if you see them, you should understand that they are all referring to the same thing.

• Glucagon-like peptide-1 agonists
• GLP-1 receptor agonists
• Incretin mimetics
• GLP-1 analogs

This type of medication is relatively new. The first GLP-1 agonist (Exenatide) was approved in 2005. So researchers are still exploring the other uses and benefits of this medication.

What are the current types of GLP-1 agonist medications?

These are some of the main GLP-1 agonist medications currently on the market. Your doctor may have prescribed one of these for you.

In addition to this, there is another class of drugs that work in a similar way. They are called dual GLP-1/GIP receptor agonists. There is currently one drug of this type. That is Tirzepatide (Mounjaro®).

How does this medicine work inside the body?

To understand how this medication works, we first need to know a little about a hormone called GLP-1 that is naturally present in our bodies.

GLP-1 is a hormone produced by your small intestine. It's like a messenger inside our bodies. It does several key things:

1. Stimulates the production of insulin by the pancreas: Insulin is an essential hormone that helps convert the food we eat into energy. It does this by reducing the amount of sugar (glucose) in the blood. If there is not enough insulin, the blood sugar level rises and diabetes develops. So the GLP-1 hormone gives the pancreas a "signal", saying, "Okay, produce insulin now."

2. Stops the production of the hormone Glucagon: Glucagon is a hormone that works against insulin. That is, it *increases* blood sugar levels when needed. So, by stopping the production of glucagon, the hormone GLP-1 prevents the addition of extra sugar to the blood.

3. Slows down the emptying of the stomach: Simply put, it increases the time the food you eat stays in your stomach. This allows the sugar from the food to enter your bloodstream more slowly. This helps control the sudden spike in blood sugar levels.

4. Increases the feeling of fullness after eating: The GLP-1 hormone also affects the parts of our brain that control hunger and fullness. Therefore, even after eating a small amount, we feel full and our appetite decreases.

Now, do you understand how the natural GLP-1 hormone works? Okay, now let's see what happens with the drug. What a GLP-1 agonist drug does is behave like the natural hormone. That is, it "mimics" that hormone. When the drug enters the body, it binds to the receptors for the GLP-1 hormone and does exactly the same thing as mentioned earlier. As the dose of the drug increases, this effect also increases.

If you have type 2 diabetes, this medicine controls blood sugar levels by increasing insulin production and controlling stomach emptying.

Because it increases the feeling of fullness, the amount of food eaten decreases, and the appetite decreases. When all of this is combined, the result is weight loss.

Who should use this medicine?

Doctors mainly prescribe this medication for two conditions: type 2 diabetes and obesity.

Type 2 Diabetes

GLP-1 agonists are approved for the treatment of diabetes because they are very effective in lowering blood sugar levels.

There are other medications for diabetes. Metformin is usually the first choice. However, your doctor may recommend a GLP-1 agonist in the following cases:

• If diabetes is not well controlled with metformin alone.
• If you have a health condition that prevents you from taking metformin.
• If your A1C value is much higher than the target level.
• If your A1C is not controlled after three months of treatment and you have other medical conditions such as atherosclerosis , heart failure , or chronic kidney disease.

Obesity

Some GLP-1 agonists, such as Semaglutide and high-dose Liraglutide, are also approved for the treatment of obesity, as they have the potential to significantly reduce body weight. Obesity is a chronic condition in which your body mass index (BMI) is 30 or higher.

Also, a doctor may prescribe this medication to someone who has a BMI between 25 and 29.9 (overweight) and has other medical conditions that can be controlled by losing weight.

How and how often to use the medicine

Your doctor will clearly tell you when and how often to take this medicine. It is very important to follow those instructions exactly. The usual number of times to use this injection is shown in the table below.

Semaglutide also comes in tablet form. It is a medication that must be taken daily.

What are the additional benefits of this medicine?

In addition to lowering blood sugar and losing weight, research has found that these medications have several other benefits.

• Lowering blood pressure.
• Improving lipid disorders such as cholesterol in the blood.
• Reducing fatty liver disease.
• Reducing the risk of heart disease and kidney disease.
• Controlling the rate of kidney damage caused by diabetes (diabetic nephropathy).

Let's also learn about side effects.

Like any medication, GLP-1 agonists can cause side effects. However, most people don't experience these, and if they do, they go away after a few days.

Risks and Complications

GLP-1 agonists are generally safe medications, but there are some risks to be aware of.

Allergic Reactions

Some people may have an allergic reaction to this medicine. If you have persistent itching or redness at the injection site, talk to your doctor. Very rarely, a serious allergic reaction called anaphylaxis can occur. If you experience any of the following symptoms, call an ambulance or go to the nearest emergency room (ETU).

• Difficulty breathing
• Hives
• Difficulty swallowing
• A red rash
• Stomach pain
• Chest tightness

Use during pregnancy

GLP-1 agonists are not recommended for use during pregnancy. Animal studies have shown that this medication may harm the developing fetus. You should use adequate birth control to prevent pregnancy while taking this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Low blood sugar levels (Hypoglycemia)

The risk of low blood sugar (hypoglycemia) is low when you take this medicine alone. However, if you take other diabetes medicines, such as insulin or sulfonylureas, along with this medicine, this risk increases significantly.

Hypoglycemia is a condition where blood sugar levels fall below 70 mg/dL. If not treated quickly, it can be life-threatening.

Characteristics:

• Body tremors
• Sweating and feeling cold
• Dizziness and blue eyes
• Lifeless body
• Heart palpitations
• Feeling very hungry
• Difficulty concentrating
• Pale skin
• Nausea

If you experience these symptoms, you should quickly eat something containing sugar or carbohydrates. For example, half a banana or half a cup of apple juice.

When should I talk to the doctor?

If you are using a GLP-1 agonist, you should see your doctor regularly to see how well it is working. In addition, talk to your doctor about the following:

• If the side effects bother you.
• If you feel that the medicine is not helping your condition.
• If you feel like stopping the medication.
• If you are pregnant or planning to become pregnant.

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