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Treatment potential of the GLP-1 receptor agonists in type 2 diabetes mellitus: a review

L Østergaard1, Christian S Frandsen1, S Madsbad1

  • 1a Department of Endocrinology, Hvidovre Hospital , University of Copenhagen , Copenhagen , Denmark.

Expert Review of Clinical Pharmacology
|November 18, 2015
PubMed

Insights

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) offer new type 2 diabetes treatments, effectively lowering HbA1c and body weight. Common side effects include nausea, with rare hypoglycemia when not combined with insulin or sulfonylureas.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have emerged as a significant advancement in managing type 2 diabetes mellitus (T2DM).
  • These agents mimic the physiological actions of native GLP-1, influencing glucose homeostasis and appetite regulation.
  • The expanding therapeutic landscape now includes multiple approved GLP-1 RAs.

Purpose of the Study:

  • To review and synthesize findings from phase III clinical trials of all approved GLP-1 RAs.
  • To evaluate the efficacy and safety profile of GLP-1 RAs in patients with T2DM.
  • To provide insights into future treatment modalities involving GLP-1 RAs.

Main Methods:

  • Systematic review of phase III clinical trial data for approved GLP-1 receptor agonists.
  • Analysis of reported efficacy outcomes, including HbA1c and fasting plasma glucose levels.
  • Assessment of adverse event profiles and body weight changes.

Main Results:

  • All evaluated GLP-1 RAs demonstrated significant reductions in HbA1c and fasting plasma glucose.
  • A majority of trials reported a notable decrease in body weight among patients treated with GLP-1 RAs.
  • The most frequent adverse events were gastrointestinal in nature, primarily nausea; hypoglycemia was infrequent, especially when not co-administered with sulfonylureas or insulin.

Conclusions:

  • GLP-1 RAs represent a valuable therapeutic class for T2DM, offering glycemic control and weight reduction benefits.
  • Understanding the adverse event profile is crucial for safe and effective patient management.
  • Future treatment strategies may involve combination therapies, such as basal insulin and GLP-1 RA co-formulations.
Keywords:
GLP-1 receptor agonistalbiglutidedulaglutideexenatideliraglutidelixisenatidetype 2 diabetes mellitus

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