Do you have Type 2 diabetes? Or are you struggling with excess body weight (obesity)? Then your doctor may have told you about a new type of medication that is being talked about by many people these days. So today, let's talk about this class of drugs called GLP-1 agonists. Let's talk about what these are, how they work, and who they are suitable for.
What are GLP-1 agonists?
Simply put, GLP-1 agonists are a class of drugs that help control blood sugar (glucose) levels, primarily in people with Type 2 diabetes . Some of these drugs also help control obesity, or excess body weight .
Most of these medications come as an injection. This means that you need to use a syringe and needle to inject a liquid medicine. This injection is given into the fatty tissue under the skin (subcutaneous injection). This injection is usually given in areas where there is fat on the stomach, back of the thighs, upper buttocks, and back of the arms. There are also oral medications available, such as Semaglutide tablets (Rybelsus®).
This group of drugs is also known by several other names:
- Glucagon-like peptide-1 agonists
- GLP-1 receptor agonists
- Incretin mimetics
These medications are relatively new. The first GLP-1 agonist (exenatide) was approved in 2005. Researchers are still exploring other uses for these drugs.
But one thing to remember: GLP-1 agonists alone cannot completely cure diabetes or obesity. Both conditions require good diet and lifestyle changes .
How does this medicine work in the body?
To understand how this medication works, let's first look at a hormone that is naturally produced in our bodies called GLP-1. GLP-1 is a hormone produced by our small intestine. It does several things in our body.
- Helps the pancreas release insulin: Insulin is a hormone that is essential for converting the food we eat into energy. It reduces the amount of sugar in the blood. If there is not enough insulin, the blood sugar level increases and diabetes develops.
- Glucagon hormone is blocked: Glucagon is a hormone that increases blood sugar levels when needed. So, GLP-1 blocks this, preventing unnecessary sugar from accumulating in the blood.
- Slows down the rate of stomach emptying: When the food we eat is digested and emptied from the stomach at a slower rate, the sugar from the food is absorbed into the blood. This controls the sudden spike in blood sugar.
- Eating creates a feeling of fullness (satiety): The GLP-1 hormone affects the parts of our brain that control hunger and fullness.
Now, what this GLP-1 agonist drug does is behave exactly like the GLP-1 hormone in our body. That is, it works 'like' it. This drug binds to the GLP-1 receptors and causes the same actions as the natural hormone. The higher the dose of the drug, the greater this effect.
Who is this medication recommended for?
Doctors mainly prescribe these GLP-1 agonist medications for two conditions: Type 2 diabetes and obesity.
For Type 2 Diabetes
GLP-1 agonists may be prescribed by your doctor, either in combination with the main diabetes medication (metformin), if it does not adequately control your blood sugar, or for other reasons. Specifically:
- If blood sugar control is not enough with metformin alone.
- If you cannot take metformin for other health reasons.
- If your A1C level is much higher than the target.
- If you have other conditions such as heart disease, congestive heart failure, or chronic kidney disease along with diabetes.
For Obesity
GLP-1 agonists such as Semaglutide and Liraglutide are also approved as treatments for obesity because they help with weight loss. Obesity is defined as a body mass index (BMI) of 30 or higher. Doctors may also prescribe these medications to people who are overweight (BMI 25-29.9) and have other health problems (e.g., high blood pressure, cholesterol), as losing weight can help control those conditions.
Can people with Type 1 diabetes take these?
This is still in the research phase. It has not yet been officially approved as a treatment for Type 1 diabetes. However, some doctors may prescribe it "off-label" as needed. It is best to talk to your doctor about this.
Learn about the use of medication and its side effects.
Your doctor will decide how often you should take this medicine. It is very important to follow those instructions exactly.
| Drug name (GLP-1 Agonist) | Frequency to take |
|---|---|
| Dulaglutide (Trulicity®) | Once a week |
| Exenatide (Byetta®) | Twice a day |
| Liraglutide (Victoza®) | Once a day |
| Semaglutide (Ozempic®, Rybelsus®) | Once a week (injection) / daily (pills) |
What are the side effects of this medication?
Like any medicine, these can have side effects.
- Common side effects: These are most often seen early in the course of treatment.
- Appetite
- Nausea
- Vomiting
- Diarrhea
- Other side effects:
- Dizziness
- Slightly faster heartbeat
- Headache
- An upset stomach
- Rare but potentially serious side effects:
- Pancreatitis
- A type of thyroid cancer (Medullary thyroid cancer)
- Acute kidney injury
- Worsening diabetes-related retinopathy
What are the risks of these medications?
Although this medication is generally safe, there are a few things to be aware of.
Allergic Reactions
Some people may have an allergic reaction to this medication. If you have persistent itching or redness at the injection site, tell your doctor. However, a severe allergic reaction called anaphylaxis is an emergency.
If you experience symptoms such as difficulty breathing, body aches, difficulty swallowing, or chest tightness , go to the nearest hospital's Emergency Department (ETU) immediately.
Use during pregnancy
GLP-1 agonists are not recommended for use during pregnancy . If you are taking this medication, you should use a reliable method of birth control. If you become pregnant while taking this medication, see your doctor immediately.
Low blood sugar (Hypoglycemia)
The risk of hypoglycemia is low when you take this medicine alone. However, if you take it with other diabetes medicines, such as insulin or sulfonylureas, the risk of hypoglycemia is higher. If your blood sugar drops below 70 mg/dL, you may experience symptoms such as shakiness, sweating, dizziness, and extreme hunger. If this happens, you should eat something with sugar (such as a sugary drink, a banana) as soon as possible.
Take-Home Message
- GLP-1 agonists are a type of medication that is used to treat Type 2 diabetes and obesity, and are mostly given as injections.
- This medicine works like the GLP-1 hormone in our body, increasing insulin production, creating a feeling of fullness, and helping with sugar and weight control.
- When using this medication, it is essential to make changes in lifestyle and eating habits. Medication alone is not enough.
- Side effects like nausea and vomiting are common at first. However, if you experience severe allergic symptoms (such as difficulty breathing) , go to the ETU immediately.
- Avoid using this medicine during pregnancy.
- Only discuss with your doctor whether this medication is right for you, how to use it, and what the dosage is.
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