What are GLP-1 Drugs
GLP-1 (glucagon-like peptide-1) drugs are a class of medications used in the treatment of type 2 diabetes. Recently GLP 1 drugs are used for weight management as well.
GLP-1 is a naturally occurring hormone that helps us in regulating blood sugar levels. These drugs mimic the action of GLP-1 by increasing insulin secretion, reducing glucagon production, slowing down gastric emptying, and promoting a feeling of fullness.
This combination of effects helps to improve blood glucose control and may lead to weight loss.
GLP 1 related Terminology to Understand
GLP-1 Drugs or GLP-1 agonists or GLP-1 receptor agonist.
GLP-1 receptor agonist is the more precise term, as it directly indicates the action of these drugs on the GLP-1 receptors.
GLP-1 Agonist: This term implies that the drug is an agonist (activator) of the GLP-1 pathway.
GLP-1 Receptor Agonist: This term specifically highlights that the drug acts on the GLP-1 receptors in the body. GLP-1 drugs mimic the action of GLP-1, a natural hormone that helps regulate blood sugar levels. They activate the GLP-1 receptors, leading to increased insulin secretion, reduced glucagon production, slowed gastric emptying, and appetite suppression.
Why GLP 1 Drugs are so popular?
GLP-1 (glucagon-like peptide-1) drugs have gained popularity for several reasons:
Effective Blood Sugar Control: GLP-1 receptor agonists help regulate blood sugar levels by increasing insulin secretion and reducing glucagon production. This is especially beneficial for individuals with type 2 diabetes.
Weight Loss Benefits: Many GLP-1 drugs have been associated with weight loss as a side effect. This makes them attractive for individuals with diabetes who also struggle with weight management.
Cardiovascular Benefits: Some GLP-1 drugs have demonstrated cardiovascular benefits, reducing the risk of major cardiovascular events in individuals with diabetes.
Once-Weekly Formulations: The availability of once-weekly injectable formulations (e.g., tirzepatide, semaglutide, dulaglutide, etc) improves convenience and adherence compared to daily medications.
Oral Formulations: The introduction of oral GLP-1 receptor agonists provides an alternative for those who prefer oral medications over injectables.
Improved Tolerance: GLP-1 drugs generally have a favorable side effect profile, with a lower risk of hypoglycemia compared to some other diabetes medications.
Potential Role in Obesity Management: Due to their appetite-suppressing effects and weight loss benefits, GLP-1 drugs have also been explored for use in obesity management.
How Do GLP-1 Agonists Work in stomach
GLP-1 agonists are special medicines that help manage blood sugar levels, mainly for people with type 2 diabetes. Imagine your stomach as a food processing center. When you eat, your body needs to handle the sugar that comes from food. GLP-1 agonists work like helpers in this process.
They tell your pancreas to release insulin, a hormone that controls sugar levels. Also, they slow down how fast food leaves your stomach, making you feel full longer. This slow-down in the stomach helps in controlling appetite and food intake. This can help with weight loss too. These medicines are like smart managers in your stomach, ensuring everything works smoothly and healthily!
GLP-1 Drugs List
GLP-1 drugs can be categorized in 2 different ways, based on how they are administered
Injectable GLP-1 Agonists:
1. Trulicity (Dulaglutide)
Frequency: Once weekly shot
Strengths available:
- 0.75mg Injectable Pen
- 1.5mg Injectable Pen
- 3mg Injectable Pen
- 4.5mg Injectable Pen
2. Victoza (Liraglutide)
Frequency: Once Daily shot
Strengths available:
- 18mg/3ML Injectable Pen
3. Saxenda (Liraglutide)
Frequency: Once Daily shot
Strengths available:
- 18mg/3 ML Injectable Pen
4. Ozempic (Semaglutide)
Frequency: Once Weekly shot
Strengths available:
- 0.25mg Injectable Pen
- 0.5mg Injectable Pen
- 1mg Injectable Pen
- 2mg Injectable Pen
5. Mounjaro (Tirzepatide)
Frequency: Once Weekly shot
Strengths available:
- 2.5mg Injectable Pen
- 5mg Injectable Pen
- 7.5mg Injectable Pen
- 10mg Injectable Pen
- 12.5mg Injectable Pen
- 15mg Injectable Pen
6. Zepbound (Tirzepatide)
Frequency: Once Weekly shot
Strengths available:
- 2.5mg Injectable Pen
- 5mg Injectable Pen
- 7.5mg Injectable Pen
- 10mg Injectable Pen
- 12.5mg Injectable Pen
- 15mg Injectable Pen
7. Byetta (Exenatide)
Frequency: Twice Daily shot
Strengths available:
- 5 mcg per dose Injectable Pen
- 10 mcg per dose Injectable Pen
Oral GLP-1 Agonists:
Semaglutide (Rybelsus)
Frequency: Once Daily Tablet
Strengths available:
- 3mg Tablet
- 7mg Tablet
- 14mg Tablet
Here are some additional information regarding Oral and Injectable GLP drugs:
- Injectable GLP-1 agonists are generally more effective than oral GLP-1 agonists.
- Oral GLP-1 agonists may be a good option for people who are afraid of needles or who have difficulty with injections.
- Injectable GLP-1 agonists are typically covered by insurance, while oral GLP-1 agonists may not be.
GLP-1 Drugs Side effects Profile
Common Side Effects of GLP-1 drugs
GLP-1 receptor agonists, which are used to treat type 2 diabetes and, in some cases, obesity, may have common side effects. It’s important to note that not everyone will experience these side effects, and the severity can vary from person to person. Common side effects of GLP-1 receptor agonists may include:
Gastrointestinal Issues:
These can include nausea, vomiting, diarrhea, and constipation. These symptoms often improve over time.
Injection Site Reactions:
For drugs administered by injection, there may be redness, swelling, or itching at the injection site.
Headache:
Some people may experience headaches, although this is generally mild and temporary.
Hypoglycemia:
While GLP-1 receptor agonists themselves are not known to cause hypoglycemia (low blood sugar) when used alone, they are often used in conjunction with other diabetes medications that can lower blood sugar. Therefore, hypoglycemia may occur if the dosage of other medications is not adjusted appropriately.
Weight Loss:
While this is often a desired effect, excessive weight loss can occur in some individuals.
Rare / Serious Side Effects of GLP-1 drugs
While GLP-1 receptor agonists are generally well-tolerated, like any medication, they can be associated with serious side effects, although these are relatively rare. It’s important for individuals using these drugs to be aware of potential serious side effects and seek medical attention if they occur. Serious side effects of GLP-1 receptor agonists may include:
Pancreatitis:
In rare cases, there have been reports of inflammation of the pancreas (pancreatitis), which can be a serious condition. Symptoms may include severe abdominal pain that persists.
Thyroid C-Cell Tumors:
Studies in rodents have shown an increased risk of thyroid C-cell tumors with certain GLP-1 receptor agonists. The relevance of this finding to humans is still under investigation.
Acute Kidney Injury:
Some individuals may experience acute kidney injury, particularly those with pre-existing kidney problems.
Weight Loss Drugs Stomach Paralysis
Stomach paralysis, or gastroparesis, is a condition where the muscles in the stomach don’t work properly, which leads to delayed emptying of the stomach contents into the small intestine.
Weight loss drugs especially GLP-1 category medications are generally safe and effective. However, there is a small risk of developing stomach paralysis. Gastroparesis occurs when the muscles in the stomach become weak or damaged, preventing the stomach from emptying properly. As a result of this condition, it causes symptoms such as nausea, vomiting, abdominal pain, and a feeling of fullness.
Gastroparesis from GLP-1 drugs is thought to be related to the way these drugs slow down the emptying of the stomach.
The risk of Stomach paralysis is higher in people who are already at risk for the condition, such as those with diabetes, autoimmune diseases, or a history of stomach surgery.
Drugs Weight Loss
Trulicity Weight Loss
Trulicity is a medicine for adults with type 2 diabetes. It’s not really a diet pill, but some people noticed they lost a bit of weight while taking it.
People taking Trulicity often lose between 2 to 6 pounds. But, it’s not the same for everyone. Some might even gain weight.
One of the studies, AWARD-11, found that with a 4.5 mg dose of Trulicity, people lost about 10.4 pounds on average.
Source: https://www.trulicity.com/
Victoza Weight Loss
Victoza isn’t officially approved by the FDA for weight loss, but studies have shown that adults using it for type 2 diabetes did lose some weight.
In one study, people using Victoza alone for 52 weeks lost about 5.5 pounds with the 1.8 mg dose and 4.6 pounds with the 1.2 mg dose.
When Victoza was combined with metformin, another diabetes medicine, adults lost up to 6.2 pounds over 26 weeks.
Another study called the SCALE study looked at Victoza for weight management in non-diabetic obese patients. They found that with a 3 mg daily dose, patients lost an average of 7.2 kg (about 15.9 pounds), which was more than what was lost with a placebo or with the drug Orlistat.