Injectable GLP-1 Agonists and Type 2 Diabetes
Over the last few years, a new category of injectable medications has become available for managing type 2 diabetes. They aren’t insulins or insulin replacements. They are GLP-1 agonists and are used to bring down blood glucose levels when other diabetes medications have stopped working or become less effective. Additionally, for many people taking these injectables, the benefits go beyond better blood glucose management.
What are GLP-1 agonists? How do they help bring down glucose levels? What other positive effects do they have? Are there any cautions to using them?
Let’s take a look.
What is GLP-1?
GLP-1 (glucagon-like peptide 1) is a hormone produced in the small intestine that stimulates insulin production and inhibits glucagon secretions. Together, this combined action brings down blood glucose levels.1
What is an injectable GLP-1 agonist?
An injectable GLP-1 agonist is a medicine that mimics the hormone GLP-1. They are used by people with type 2 diabetes to improve their blood glucose management.1
There are several forms of injectables available, including exenatide, semaglutide, dulaglutide, and liraglutide. Depending on the form, they are injected daily (at the same time of day) or weekly. You may have heard of Bydureon, Ozempic, Trulicity, or Victoza. These are brand names for some of the various forms of injectable GLP-1 agonists available in the U.S.1
Who can benefit from using a GLP-1 agonist?
People with type 2 diabetes who are finding that the diabetes medications they’re taking are no longer as effective for managing their blood glucose levels, stand to benefit the most from using an injectable GLP-1 agonist.
What other benefits do GLP-1 agonists offer?
GLP-1 agonists offer a number of benefits beyond improving blood glucose management.
For many people, they promote weight loss. On average the reported weight loss is between 3 and 5.5 lbs (1.5 to 2.5 kg). When combined with lifestyle changes an additional 6 to 9 lbs. (2.8 to 4.2 kg) of weight loss has been reported with GLP-1 agonist use. It’s thought that GLP-1 agonists promote weight loss through some combination of appetite suppression, feeling full faster and for longer, and/or slowing the movement of food from the stomach to the small intestine.2
Improved blood pressure and cholesterol
Some people taking GLP-1 agonists find that their blood pressure and/or cholesterol levels improve. Studies are also finding that using a GLP-1 agonist is linked to lowering the risk of heart attack, heart disease, stroke, and kidney disease. It’s thought that these additional benefits are tied to weight loss.2
Low risk of hypoglycemia
GLP-1 agonists also have a low risk of hypoglycemia. Hypoglycemia, or extremely low blood glucose levels, can be dangerous. At its most extreme it can cause seizures and lead to an early death.3
What are the potential downsides of injectable GLP-1 agonists?
Some people experience nausea or other gastrointestinal effects when using GLP-1 agonists. For many, these effects become weaker over time. But for some people, they find these effects intolerable.
GLP-1 agonists have been linked to thyroid tumors developing in rats. Because of this, they are not recommended for people who have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia.3
Risk of pancreatitis has also been identified with taking GLP-1 agonists. So they are not recommended for people who have had pancreatitis.3
Are injectable GLP-1 agonists right for you?
If you are finding that your current self-care routine and medications are just not as effective as they used to be at keeping your blood glucose levels in check, you may want to discuss with your doctor possibly using an injectable GLP-1 agonist.
Do you live with any sleep disorders (eg. insomnia, sleep apnea, RLS) in addition to your diabetes?