A review of practical issues on the use of glucagon-like peptide-1 receptor agonists for the management of type 2 diabetes
Open accessAbstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well established as effective treatments for patients with type 2 diabetes. GLP-1 RAs augment insulin secretion and suppress glucagon release via the stimulation of GLP-1 receptors. Although all GLP-1 RAs share the same underlying mechanism of action, they differ in terms of formulations, administration, injection devices and dosages. With six GLP-1 RAs currently available in Europe (namely, immediate-release exenatide, lixisenatide, liraglutide; prolonged-release exenatide, dulaglutide and semaglutide), each with its own characteristics and administration requirements, physicians caring for patients in their routine practice face the challenge of being cognizant of all this information so they are able to select the agent that is most suitable for their patient and use it in an efficient and optimal way. The objective of this review is to bring together practical information on the use of these GLP-1 RAs that reflects their approved use.Funding: Eli Lilly and Company.Plain Language Summary: Plain language summary available for this article.
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GLP-1 RAs may require dose adjustment at low eGFR.
“Of note, GLP-1 RAs may also be used at low eGFR for cardiovascular protection but may require dose adjustment (121).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [121]
The section “Precautions for the Use of GLP-1 RAs in Special Populations” (page unavailable) says immediate-release exenatide requires dose escalation in moderate renal impairment, supporting the possibility of a dosing change at lower eGFR. It also says several agents need no adjustment in severe impairment and others are not recommended there. The “Place of GLP-1 RAs in the Treatment of T2D” section discusses cardiovascular benefits generally, but does not establish cardiovascular protection specifically at low eGFR. (LLM, conf=0.84)
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- Authors
- Romera, I., Cebrián-Cuenca, A., Álvarez-Guisasola, F., Gomez-Peralta, F., & Reviriego, J.
- Affiliations
- Eli Lilly (Spain) (ES)
- Corresponding author
- Romera, Irene
- Venue
- Diabetes Therapy
- Published
- 2018-11-30
- Volume
- 10
- Issue
- 1
- Pages
- 5-19
- ISSN
- 1869-6953 (ISSN-L)
- 1869-6961
- PMC
- PMC6349277
- OpenAlex
- W2902989158
- Cited by
- 77
- References
- 64
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 11 · 2023: 10 · 2022: 13 · 2021: 14 · 2020: 12 · 2019: 7 · 2018: 1
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Therapy (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- GLP-1 receptor agonists, type 2 diabetes, exenatide, lixisenatide, liraglutide, dulaglutide, semaglutide, insulin secretion, glucagon suppression, drug formulation, injection device, dosage, treatment selection
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