Glucagon-like peptide-1 receptor agonists, aka GLP-1 agonists, corresponding to semaglutide — higher generally known as Ozempic — have gained reputation globally, not only for managing kind 2 diabetes but in addition as a consequence of their weight reduction advantages. This enhance in reputation is principally as a consequence of celeb endorsements and the ability of social media. In accordance with a analysis letter revealed final 12 months, the variety of semaglutide fills elevated by 442% between 2021 and 2023. Ozempic accounted for over 70% of these fills.
Its reputation has even influenced wholesale retailer Costco to promote Ozempic and Wegovy (one other fashionable semaglutide) at its pharmacy to clients with out medical insurance at a closely discounted fee of $499 a month. In accordance with GoodRX, Wegovy can price $1,590.47 and Ozempic $1,216.69 at full worth.
Past kind 2 diabetes and weight reduction, GLP-1 agonists can even assist decrease blood strain, enhance lipid issues, cut back irritation and enhance coronary heart well being. With such benefits, the demand for GLP-1 agonists continues to develop, making them probably the most talked-about remedies at this time.
What are GLP-1 agonists?
GLP-1 agonists, also called incretin mimetics, are a category of treatment that’s primarily used to deal with kind 2 diabetes and, in some instances, weight problems.
“The glucagon-like peptide (GLP-1) is a naturally occurring hormone within the small gut which triggers the discharge of insulin from the pancreas. This course of helps to manage blood sugar ranges,” mentioned Angela Haynes-Ferere, affiliate professor at Emory College of Nursing in Atlanta. “The GLP-1 agonist mimics the motion of this naturally occurring hormone. After consuming, blood sugars will rise, and these medicines trigger the pancreas to launch extra insulin which helps to decrease blood sugar.”
Along with serving to folks with kind 2 diabetes management their blood sugar, this treatment reduces one’s urge for food. It additionally slows the digestive course of so sufferers report feeling full with much less meals consumption. This leads to weight reduction for a lot of customers, nevertheless it varies primarily based on many individualized elements, mentioned Haynes-Ferere.
In accordance with Cleveland Clinic, a lot of the GLP-1 agonists are out there as liquid treatment that must be injected beneath the pores and skin, besides one that’s out there in pill type (Rybelsus).
A couple of generic and model names of GLP-1 agonists, based on the Johns Hopkins Affected person Information to Diabetes, embrace:
- Dulaglutide, marketed as Trulicity
- Lixisenatide, marketed as Adlyxin
- Liraglutide, marketed as Victoza
- Semaglutide, marketed as Ozempic
- Semaglutide oral, marketed as Rybelsus
- Tirzepatide, marketed as Mounjaro or Zepbound (a twin GLP-1/GIP agonist)
Every model has its personal really useful dosage and frequency of consumption. Some could also be taken as soon as day by day, whereas others are used weekly. You need to seek the advice of your physician to grasp what dosage and frequency finest swimsuit you.
Potential GLP-1 agonist advantages
“Along with controlling blood sugar and lowering weight problems, these medicines have been proven to scale back cardiovascular dangers and enhance kidney operate,” mentioned Haynes-Ferere. Anecdotally, people are reporting diminished smoking, playing, alcohol consumption and drug use, she famous.
“Research have proven advantages in worsening kidney illness, coronary heart failure and obstructive sleep apnea in sufferers with weight problems,” says Dr. Leon Jons, a weight administration specialist and medical affiliate professor of Inside Medication-Endocrinology and Metabolism at Carver School of Medication in Iowa.
In accordance with Cleveland Clinic, different advantages of GLP-1 agonists could embrace:
- Reducing blood strain
- Enhancing lipid issues
- Decreasing systemic irritation
- Delaying the development of diabetes-related nephropathy or diabetes-related kidney illness, aka DKD
These advantages not solely make GLP-1 agonists efficient for managing kind 2 diabetes but in addition contribute to raised cardiovascular well being. Nevertheless, the impact of GLP-1 agonists varies from one particular person to a different. All the time discuss to your physician to grasp how GLP-1 agonists could profit your particular situation.
GLP-1 agonist unwanted effects and dangers to contemplate
For some sufferers, the velocity of weight reduction can result in the undesired beauty impact of a gaunt face (colloquially known as “Ozempic face”), notably in sufferers with much less pores and skin elasticity, mentioned Haynes-Ferere. She added that common train with weight coaching can assist protect muscle mass and keep a wholesome look.
The medicines’ unwanted effects are predominantly associated to the gastrointestinal system — for instance, nausea, constipation, diarrhea or belching. For many sufferers, these results are delicate and resolve over time. For some, the unwanted effects may be extreme, and sufferers would want to cease the treatment, Jons mentioned.
Different widespread unwanted effects of GLP-1 agonists, as reported in a Nationwide Library of Medication article, embrace:
- Lack of urge for food
- Vomiting
- Headache
- Dizziness
- Gentle tachycardia (elevated coronary heart fee)
In some instances, minor episodes of hypoglycemia could happen. “Hypoglycemia can be extraordinarily uncommon and is extra more likely to happen in sufferers who’re additionally taking different diabetes medicines that may decrease blood sugar an excessive amount of,” mentioned Dr. Troy Mensen, a household medication physician primarily based within the Chicago space and member of the CNET medical assessment board. Cleveland Clinic studies that hypoglycemia is a situation during which blood glucose ranges drop under 70 mg/dL. If left untreated, it could turn into life-threatening. Signs of hypoglycemia could embrace shakiness, weak point, nausea, problem concentrating and dizziness. Consuming sugars or carbohydrates can deal with hypoglycemia.
Additionally, docs don’t advocate GLP-1 agonists to pregnant folks since it could pose a risk to the growing fetus. Seek the advice of your physician if you happen to’re pregnant, planning to get pregnant or are breastfeeding.
Who ought to take GLP-1 agonists?
Docs primarily advocate GLP-1 agonists for kind 2 diabetes and weight problems. Nevertheless, GLP-1 agonists aren’t the primary alternative of therapy. Metformin, an oral treatment, stays the first alternative for managing kind 2 diabetes. Nevertheless, docs could advocate GLP-1 agonists if you happen to:
- Can not tolerate metformin
- Are unable to decrease your blood sugar ranges with ongoing medicines even after three months
- Expertise problems as a consequence of different circumstances corresponding to coronary heart failure, atherosclerosis or persistent kidney illness
Cleveland Clinic studies that docs might also advocate two GLP-1 agonists, semaglutide and liraglutide, for treating weight problems. Dr. Mensen provides that tirzepatide (Mounjaro or Zepbound), a twin GLP-1/GIP agonist, might also be really useful.
“Primarily based on the truth that every particular person expertise with this treatment is totally different, the affected person ought to work with their healthcare supplier to find out one of the best therapy plan and purpose for general well-being,” mentioned Haynes-Ferere.
Moreover, GLP-1 agonists corresponding to dulaglutide, semaglutide and liraglutide have been proven to offer cardiovascular advantages. Docs might also advocate these GLP-1 agonists to cut back the chance of coronary heart illness.
The really useful frequency of consumption for generally prescribed GLP-1 agonists consists of:
- Dulaglutide: Weekly
- Liraglutide: Each day
- Semaglutide: Weekly
- Tirzepatide: Weekly
- Semaglutide tablets: Each day
Who shouldn’t take GLP-1 agonists?
Though GLP-1 agonists can assist to successfully deal with kind 2 diabetes and weight problems, they will not be appropriate for everybody. Your physician could keep away from prescribing GLP-1 agonists you probably have:
- Household historical past of medullary thyroid most cancers: This uncommon thyroid most cancers has been linked to the usage of GLP-1 agonists in rodents. Your physician could keep away from prescribing GLP-1 agonists you probably have a household historical past of medullary thyroid most cancers.
- A number of endocrine neoplasia syndrome kind 2, or MEN2: A uncommon situation characterised by tumors in endocrine glands. Docs could keep away from prescribing GLP-1 agonists you probably have been identified with or have a household historical past of MEN2 since they’ll stimulate irregular cell progress.
- Pregnant folks: Docs could not advocate GLP-1 agonists to pregnant folks since it will possibly pose a danger to the growing fetus.
- Historical past of pancreatitis: Docs most frequently keep away from GLP-1 agonists in folks with a historical past of pancreatitis since GLP-1 agonists could enhance the chance of deadly hemorrhagic and necrotizing pancreatitis.
- Inflammatory bowel issues or gastroparesis: GLP-1 agonists sluggish gastric emptying and will worsen signs of inflammatory bowel issues.
GLP-1 overdoses and essential data to recollect
GLP-1 agonists are prescription medicines and ought to be taken solely beneath the supervision of your physician. Following the really useful dosage can assist to forestall overdoses. In accordance with America’s Poison Facilities, an overdose of GLP-1 typically causes comparable signs to unwanted effects:
- Nausea
- Diarrhea
- Vomiting
- Belly ache
- Constipation
Nevertheless, the period of those signs could also be longer. In extreme instances, you may additionally expertise dehydration and hypoglycemia, which can require quick medical consideration.
You need to double-check the dose earlier than taking the treatment and set a reminder for the following dose to forestall the chance of overdose.
When to contact a health care provider
You need to contact your physician if you happen to’re experiencing severe unwanted effects after utilizing a GLP-1 agonist, corresponding to:
- Nausea
- Belly ache
- Dizziness
- Improve in coronary heart fee
- Shaking or trembling
Additionally, seek the advice of your physician first if you happen to suppose the treatment isn’t working for you or if you happen to’re contemplating not persevering with the treatment.
Moreover, scheduling common follow-ups along with your physician when you’re on GLP-1 agonists is essential. These follow-ups assist monitor your blood glucose ranges and decide if any dosage modifications are needed. Common follow-ups can even assist docs monitor indicators of hypoglycemia, renal illness, pancreatitis and thyroid most cancers.
The underside line
GLP-1 agonists are medicines that primarily deal with kind 2 diabetes and weight problems. Nevertheless, latest research recommend they’ll decrease blood strain, cut back irritation and enhance lipid issues. A number of manufacturers can be found, every having their very own dosage tips. Nevertheless, GLP-1 agonists will not be appropriate for everybody. You need to discuss to your physician to grasp whether or not it’s best to take GLP-1 agonists on your situation.