The Incretin Revolution: Integrating Incretin-Based Therapies into Clinical Care

Incretin-based therapies have changed the landscape of modern medical practice. Obesity-related disease processes including type 2 diabetes mellitus, cardiovascular disease, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, and obstructive sleep apnea improve in patients treated with these medications, and several now carry organ-specific regulatory indications. In this narrative review we summarize the mechanisms through which these medications act, appraise the evidence for each indication by study design and endpoint status, and set out a practical framework for integrating incretin therapy into care outside endocrinology, covering agent selection by dominant comorbidity, sequencing with other disease-modifying therapy, monitoring, safety and long-term management, and prescribing where access is constrained.