GLP-1 Receptor Agonists

Glucagon-like peptide-1 (GLP-1) receptor agonists are drugs that treat type 2 diabetes and obesity. They are in a class of drugs known as incretin mimetics. GLP-1 drugs are more commonly known by their brand names like Ozempic, Wegovy (semaglutide), Mounjaro (tirzepatide), and Victoza (liraglutide). These medications work by regulating insulin production and lowering blood sugar levels. This also often results in weight loss.

GLP-1 drugs are typically injectable medications, and people administer them with a needle injection just under the skin. Some oral GLP-1 drugs are also available, however. Your healthcare provider may prescribe a GLP-1 drug if you live with type 2 diabetes or are at risk of diabetes complications such as hypertension (high blood pressure) or heart disease. At this time, GLP-1 drugs are not available over the counter. 

How GLP-1 Drugs Work

Most people who take GLP-1 medications live with type 2 diabetes. People with type 2 diabetes aren't able to use insulin properly, which results in high blood sugar levels. Insulin is responsible for removing sugar from the blood into your body tissues that use it for energy. However, GLP-1 drugs can help this condition in several ways.

Lowering Blood Sugar

GLP-1 drugs work by regulating insulin production and lowering blood sugar—which helps manage diabetes effectively. These medications do this by activating the GLP-1 receptors in your cells and stimulating your pancreas to release the right amount of insulin after eating. 

Promoting Satiety

While improving insulin processing is a key benefit of this drug class, GLP-1 also promotes a feeling of fullness (satiety) after eating by slowing down digestion, often leading to weight loss. This process is known as delayed gastric emptying and causes you to feel less hungry throughout the day. Most GLP-1 drugs help treat type 2 diabetes. But, some GLP-1 medications like Saxenda (liraglutide) have been approved to treat obesity as well.

Reducing Risk of Diabetes Complications

GLP-1 drugs may also lower the risk of diabetes complications. People with type 2 diabetes are at increased risk of high blood pressure, high cholesterol, heart disease, stroke, kidney problems, nerve damage, and vision problems. By keeping insulin and blood sugar levels in a healthy range, GLP-1 drugs lower the risk of these serious complications. 

Your healthcare provider may prescribe GLP-1 drugs or may refer you to an endocrinologist (a medical doctor who specializes in the treatment of diabetes and other endocrine system disorders). Your provider may recommend incorporating a GLP-1 drug into your treatment plan to lower the risk of heart attack, stroke, or death associated with type 2 diabetes. Keep in mind: these drugs are not meant to be used in place of insulin. 

Types of GLP-1 Drugs

GLP-1 drugs are in a class of drugs known as incretin mimetics. They are available as short-acting or long-acting medications. The type of GLP-1 drug you have will affect how often you administer it. 

Short-Acting GLP-1 Drugs

Short-acting GLP-1 drugs lower blood sugar after eating by slowing down digestion. They stay in your body for less than a day and are usually taken once or twice daily.

Examples of short-acting GLP-1 drugs include:

• Byetta (exenatide)
• Adlyxin (lixisenatide)
• Rybelsus (oral semaglutide)
  

Long-Acting GLP-1 Drugs

Long-acting GLP-1 drugs control blood sugar levels throughout the day by stimulating the pancreas to secrete the right amount of insulin after eating. These drugs stay in your body for up to one week. 

Examples of long-acting GLP-1 drugs include:

• Victoza (liraglutide)
• Bydureon (exenatide) 
• Trulicity (dulaglutide)
• Wegovy and Ozempic (semaglutide)
  

How Are GLP-1 Drugs Given?

Most GLP-1 drugs are available as subcutaneous injections. Subcutaneous tissue is fat tissue just below the skin. GLP-1 drugs usually come in the form of prefilled syringes or pens. Most people inject the medication into the fat tissue in their abdomen, inner thighs, and upper arms. Healthcare providers recommend rotating which area you inject the drug into to prevent bruising or irritation. 

Your healthcare provider may start with a low-dose prescription and gradually raise the dose as needed. Before administering the medication, always check the expiration date and inspect the solution. It should look clear without any particles or cloudiness. It's also important to store your GLP-1 prescription in a cool, dry place out of reach of children and pets. Your provider may recommend storing the medication in the refrigerator. Never freeze the pens or syringes. 

Potential Side Effects

There are several possible side effects of GLP-1 drugs, so it's important to talk with your healthcare provider about the potential benefits and risks before starting a new medication. 

Mild side effects when starting a new GLP-1 drug may include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain
• Heartburn 
• Burping 

Potentially serious side effects of GLP-1 drugs may include: 

• Pancreatitis: Inflammation of the pancreas that feels like abdominal pain in the upper left or middle of the stomach that spreads to the back
• Anaphylaxis: A life-threatening reaction that may cause difficulty breathing and swallowing, a rash, and swelling in the face, mouth, tongue, and throat
• Hypoglycemia: Dangerously low blood sugar levels that may cause hunger, shakiness, dizziness, lightheadedness, sweating, confusion, headache, blurred vision, slurred speech, weakness, rapid heart rate, irritability, anxiety, and mood changes

If you experience any signs of a serious side effect or reaction to a GLP-1 drug, contact your healthcare provider immediately or seek emergency medical care. 

Other Considerations

There are several factors to consider before beginning a new drug regimen. Do not take GLP-1 drugs if you are pregnant, breastfeeding, or planning to become pregnant. GLP-1 drugs may also affect how effective oral birth control pills are. Talk with your healthcare provider about birth control when taking GLP-1 drugs. 

It's also important to speak with your healthcare provider if you have experienced any of the following health conditions, as GLP-1 drugs may not be safe for you:

• Multiple endocrine neoplasia syndrome type 2, or MEN 2 (a rare condition that causes tumors in endocrine glands)
• Pancreatitis
• Gallbladder disease 
• Kidney disease 

In rare cases, GLP-1 drugs may also affect your mood or mental health. There is a risk of experiencing thoughts of self-harm or suicide with these drugs. If you notice these emotional changes, it's important to speak with your healthcare provider immediately.

When to Contact Your Healthcare Provider

Before starting a new medication, discuss the potential benefits and risks with your healthcare provider. If you begin to notice side effects from the drug, it's also a good idea to be in touch with your provider. Call your provider if you are experiencing any mild side effects such as nausea, diarrhea, or vomiting, as these side effects may lead to dehydration.

If you experience serious side effects or complications of GLP-1 drugs, however, seek immediate medical care. It's also imperative to go to your local emergency department or call 911 if you are experiencing an allergic reaction, pancreatitis, or hypoglycemia.

A Quick Review

Glucagon-like peptide-1 (GLP-1) receptor agonists are drugs that help treat type 2 diabetes, high blood sugar, and obesity. These drugs help regulate insulin, lower blood sugar, and promote fullness. Most GLP-1 drugs are injection medications that you can administer yourself. These medications require a prescription and are not available over the counter. Like all medications, these drugs do come with some risks, so it's important to talk to your healthcare provider about any questions or concerns you may have before starting the treatment.