An Overview on GLP-1 Agonists

One group of type 2 diabetes medications are called GLP-1 agonists — often referred to as non-insulin injectables. Common names in the US are: Victoza, Trulicity, Bydureon, Byetta, Ozempic, and Rybelsus. Most of these are taken as an injection.

How do GLP-1 agonists work?

GLP-1 agonists replace low hormone levels in your digestive system. These hormones (called GLP-1 or incretin hormones) are responsible for signaling your brain you’re full after a meal, slow how quickly you digest your food, and send a variety of signals to your pancreas (in an effort to process your food and stabilize your blood sugars).  In type 2 diabetes, GLP-1 levels are low and can cause your blood sugars to be higher after meals. Thus, this group of medications replace those hormones, creating healthier blood sugars as an end result.

The benefits of GLP-1 agonists

GLP-1 agonists usually improve someone’s A1C as much as 1.5-2%, making them one of our most powerful options for helping manage blood sugar levels. Because of the way they work, after meal blood sugars are usually impacted the most, but many people also see their fasting blood sugars improve as well.

But that’s not the only great thing about these medications. Most also decrease your risk of death from heart attack or stroke. That’s a big deal, considering heart disease is the most common complication of diabetes. Some also protect your kidneys as well.

GLP-1 agonists can make day-to-day diabetes management a little easier than other medication options. Many are available as a weekly injection and can be taken with or without food. That means you’re not having to worry about the timing of the medication or day-to-day fluctuations in your routines.

Additionally, some of these medications are available in combination with long-acting insulin (insulin that lasts 24 hours or longer). That means if you need both medications, you can get the benefit of each in one daily injection (fewer shots for you!). This combination can also be a cost-saver too.

Finally, you don’t have to worry about having low blood sugars when using GLP-1 agonists (unless you take them with a medication that can cause lows).

Minimizing side effects of GLP-1 agonists

Like any medication, there’s always a risk for side effects. The most common side effect is nausea or vomiting. If you think about how these medications work (slowing down your digestion), then these side effects would make sense.  This also means if you have other health conditions, like gastroparesis, in which your digestive tract works slower than it should, these medications may not be the right fit for you.

Eating smaller meals and avoiding high-fat meals (like fried foods) can help decrease these side effects as well.

Many of these medications have “initiation” doses, that are simply meant to get your body used to the medication. This slow introduction can help lower your chance of side effects. It also gives you and your doctor time to determine if you’re someone who will have these side effects. Doses are increased after that and you start to see changes in your blood sugars. Typically, over time, side effects decrease.

Overall, GLP-1 mediations are a great option for improving blood sugar levels and have a number of benefits beyond just blood sugar management.

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