Incretins for Type 2 Diabetes

Type 2 diabetes (T2D) is a growing global health challenge. With prevalence projected to rise significantly in the coming decades, T2D is expected to contribute to increased healthcare costs due to associated morbidity and mortality. Characterized by insulin resistance and impaired pancreatic insulin secretion, T2D could be mediated by the effects of glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Incretin-based therapies have, therefore, emerged as effective treatments for improving glycemic management and weight reduction in people with T2D. Since the approval of the first twice daily GLP-1 RA in 2005, advancements have led to the development of once-daily and once-weekly injectable formulations and an oral formulation. Furthermore, the approval of a dual GLP-1/GIP RA marked a significant milestone in incretin-based therapies. These agents have demonstrated glycemic-lowering benefits, weight loss, and reduced cardiovascular risk in high-risk populations. The most common adverse effects are gastrointestinal and can be partially mitigated with slow dose titration and patient education. Ongoing research into alternative dosing regimens, combination therapies, and strategies to improve access will be important for optimizing the long-term impact of incretin-based therapies in T2D management.