Modern medicine is continually advancing treatment options for many chronic health conditions. For type 2 diabetes and obesity, GLP-1 receptor agonists are medications that may benefit your current treatment routine.
Glucagon-like peptide-1 receptor agonists, often referred to simply as GLP-1s, are a class of medications primarily used to treat type 2 diabetes, though some formulations are also approved for the treatment of overweight and obesity.
GLP-1 receptor agonists work by mimicking the GLP-1 hormone, which your intestines secrete in response to food to help regulate blood sugar (glucose). Typically, GLP-1 is broken down by other enzymes produced in the body.
The GLP-1 hormone suppresses appetite. Appetite suppression occurs in the area of the brain known as the hypothalamus. The GLP-1 hormone also slows how quickly food leaves your stomach and affects the release of insulin and glucagon from the pancreas.
By taking a GLP-1 receptor agonist, you’re supplementing your natural levels of GLP-1, promoting its effects on your body.
While making an informed decision about adding a GLP-1 receptor agonist to treatment for newly diagnosed type 2 diabetes involves a discussion with your doctor, understanding more about this medication can provide insight into whether one is right for you.
GLP-1 receptor agonists are approved by the Food and Drug Administration (FDA) for use in type 2 diabetes. They are also approved for obesity and overweight with associated obesity-related conditions, like high cholesterol or nonalcoholic fatty liver disease. (Overweight is defined as a body mass index of 25 to 30. Obesity is defined as a BMI of 30 or above.)
If you meet one or both of those baseline criteria, GLP-1 therapy may be an option.
Who is a good candidate for GLP-1s?
Not everyone living with type 2 diabetes or obesity needs to take a GLP-1 receptor agonist.
Metformin, a type of medication belonging to a class of drugs called biguanides, remains the go-to choice for lowering blood sugar in type 2 diabetes.
If your diabetes is considered well managed on traditional therapies, your doctor may feel a GLP-1 receptor agonist is unnecessary.
If your glucose levels are very high, however, your doctor may prescribe a GLP-1 receptor agonist in addition to metformin.
- cannot take metformin
- are having difficulty reaching your target blood sugar levels over several months
- are experiencing complications related to:
When comorbidities (co-occurring conditions) are present in type 2 diabetes, GLP-1 receptor agonists are sometimes chosen for their additional cardiovascular, gastrointestinal (GI), and weight reduction benefits, which may promote better overall health.
GLP-1 receptor agonists aren’t recommended if you are:
- pregnant
- hypersensitive to GLP-1
- living with severe GI conditions, like inflammatory bowel disease (IBD)
- at increased risk of certain thyroid cancers
If you have a history of pancreatitis, kidney failure, or gallbladder disease, GLP-1 receptor agonists may not be safe for you.
There are many types of GLP-1 receptor agonists available. While they all work by mimicking the effects of the GLP-1 hormone, they feature unique formulations that have different benefits and contraindications.
The right GLP-1 receptor agonist for you will be the one that offers the most benefits with the least amount of risk based on your individual needs.
Current GLP-1 receptor agonists approved by the FDA
- semaglutide (Rybelsus, Ozempic, Wegovy)
- exenatide (Bydureon BCise, Byetta)
- lixisenatide (Adlyxin)
- lixisenatide/insulin glargine (Soliqua)
- liraglutide (Saxenda, Victoza)
- liraglutide/insulin degludec (Xultophy)
- dulaglutide (Trulicity)
When it comes to semaglutide, Ozempic is FDA approved for type 2 diabetes, and Wegovy is approved for obesity and overweight with associated obesity-related conditions.
Your doctor may also consider a combination of a gastric inhibitory polypeptide (GIP) receptor and GLP-1 receptor agonist, like tirzepatide (Mounjaro, Zepbound), which affects additional bodily processes related to insulin secretion.
Which medication your doctor recommends will depend on its proven effectiveness, safety profile, and potential benefits for other health concerns.
If weight loss is important to your type 2 diabetes treatment, for example, your doctor may prioritize a GLP-1 receptor agonist that’s shown to be highly effective for weight management.
Which type of GLP-1 is most effective for blood sugar control?
All FDA-approved GLP-1 receptor agonists for newly diagnosed type 2 diabetes treatment have been proven through clinical trials to effectively regulate blood sugar.
When it comes to the “best” one,
Which type of GLP-1 is more effective for weight loss?
For weight loss,
CagriSema is a semaglutide/cagrilintide combination drug not yet FDA approved for use in the United States.
Which GLP-1 medication has the least side effects?
Nausea, vomiting, constipation, and diarrhea are the most common side effects of GLP-1 receptor agonists, though some people also experience:
- headaches
- increased infections
- rapid heart rate
- dizziness
- indigestion
According to the 2021 review mentioned above, Exenatide XR (exenatide) had the lowest rate of GI side effects compared with semaglutide injections, which had the highest rate of GI side effects.
Almost all GLP-1 receptor agonists are administered by injection
If your doctor prescribes a GLP-1 receptor agonist injection, it will likely come in a precise dosing pen. This is a handheld device with a fine needle that allows you to adjust your dose as directed by your doctor.
It’s OK if you’re not comfortable giving yourself an injection. You can have this done at your doctor’s office, though there may be a charge for each visit.
Resources are also available, such as information on how to inject the medication, which is typically available on the pharmaceutical company’s website. Your doctor can also show you how to administer your first dose.
How quickly a GLP-1 receptor agonist becomes effective depends on the formulation. Some are fast-acting and used daily, while others are long-acting and can take weeks to reach a therapeutic dose in the body.
If you stop taking a GLP-1 receptor agonist, rebound effects are possible. As your body adjusts to the lack of GLP-1 activity, you may notice the return of symptoms like hunger, weight gain, and hyperglycemia (elevated blood sugar).
Because of this, treatment for diabetes and obesity is typically viewed as lifelong.
In the
Is GLP-1 safe for weight loss?
Currently, Wegovy and Zepbound are the only GLP-1 receptor agonists
That doesn’t mean other GLP-1 receptor agonists aren’t safe for weight loss. It just means they haven’t gone through the rigorous testing required to be labeled for that specific use.
You don’t have to wait for your doctor to suggest a GLP-1 receptor agonist before asking about it. If you feel you may be a candidate for a GLP-1 receptor agonist, be honest and upfront with your doctor about why you want to add it to your current treatment plan.
When your doctor understands your goals and the challenges you’re experiencing, they can help you make an informed decision about taking a GLP-1 receptor agonist.
Questions to help you make the most of this discussion include:
- Am I a candidate for a GLP-1 receptor agonist? Why or why not?
- Would a GLP-1 medication complement my current treatment plan?
- Which GLP-1 medication would make the most sense for me?
- 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?
- What types of follow-up appointments or tests are necessary for adding a GLP-1?
Learning as much as you can about GLP-1 receptor agonists before your appointment can also help. You can familiarize yourself with common terminology and pinpoint specific GLP-1 receptor agonists that appeal to you.
Like all medications, consistently using GLP-1 receptor agonists is important.
To ensure you’re getting the maximum medication benefits, follow these tips:
- follow dosing and administration instructions exactly as prescribed by your doctor
- have a healthcare professional help you learn proper administration techniques if using injections
- be consistent with the time of day you take the medication
- store medication properly, such as keeping it refrigerated or at room temp, depending on what the package insert says
- make lifestyle changes that promote overall health, like getting quality sleep, staying hydrated, etc.
- keep in communication with your doctor and stick to a regular follow-up schedule
- maintain a symptom journal to track any possible medication side effects or reactions
Additionally, whether you’re taking a GLP-1 receptor agonist for type 2 diabetes, obesity, or both, most are intended to be used alongside diet and exercise strategies.
GLP-1 receptor agonists are medications used to treat type 2 diabetes and obesity, depending on the brand. They mimic your body’s natural GLP-1 hormone, which helps regulate blood sugar in several ways.
Not everyone living with type 2 diabetes or obesity needs a GLP-1 receptor agonist or is a candidate for one. Your doctor can discuss the benefits and contraindications of this therapy and why it may or may not be an option for you.