Long-Acting Glucagon-Like Peptide 1 Receptor Agonists
Open accessAbstract
Targeting the incretin system has become an important therapeutic approach for treating type 2 diabetes. Two drug classes have been developed: glucagon-like peptide (GLP)-1 receptor agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors. Clinical data have revealed that these therapies improve glycemic control while reducing body weight (GLP-1 receptor agonists, specifically) and systolic blood pressure (SBP) in patients with type 2 diabetes. Furthermore, incidence of hypoglycemia is relatively low with these treatments (except when used in combination with a sulfonylurea) because of their glucose-dependent mechanism of action. There are currently two GLP-1 receptor agonists available (exenatide and liraglutide), with several more currently being developed. This review considers the efficacy and safety of both the short- and long-acting GLP-1 receptor agonists. Head-to-head clinical trial data suggest that long-acting GLP-1 receptor agonists produce superior glycemic control when compared with their short-acting counterparts. Furthermore, these long-acting GLP-1 receptor agonists were generally well tolerated, with transient nausea being the most frequently reported adverse effect. Careful consideration should be given to the selection of therapies for managing type 2 diabetes. In particular, antidiabetic agents that offer improved glycemic control without increasing cardiovascular risk factors or rates of hypoglycemia are warranted. At present, many available treatments for type 2 diabetes fail to maintain glycemic control in the longer term because of gradual disease progression as β-cell function declines. Where sulfonylureas or thiazolidinediones (common oral antidiabetic drugs) are used, the risk of hypoglycemia and weight gain can increase (1,2). The development of new therapies for the treatment of type 2 diabetes that, in addition to maintaining glycemic control, could reduce body weight and hypoglycemia risk (3,4), may help with patient management. Indeed, guidelines have been developed that support the consensus that blood pressure, weight reduction, and avoidance of hypoglycemic events should be targeted in …
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GLP-1 RAs are known to cause gastrointestinal disturbances that have been shown to negatively impact adherence and persistence.
“Furthermore, GLP-1 RAs are known to cause gastrointestinal disturbances, and while these effects may subside after initial use, they have been shown to negatively impact adherence and persistence.”
From Real-world weight change, adherence, and discontinuation among patients with type 2 diabetes initiating glucagon-like peptide-1 receptor agonists in the UK (2022) · cites this paper as [11]
The “Gastrointestinal side effects” section (page unavailable) reports that nausea and vomiting are common with long-acting GLP-1 receptor agonists and tend to be transient. It does not show a negative effect on adherence or persistence; instead, it says these effects rarely result in patient withdrawal. (LLM, conf=0.87)
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- Authors
- Garber, A. J.
- Affiliations
- Baylor College of Medicine (US)
- Corresponding author
- Garber, Alan J.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-04-22
- Volume
- 34
- Issue
- Supplement_2
- Pages
- S279-S284
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3632193
- OpenAlex
- W2109093140
- Cited by
- 350
- References
- 14
- Citations by year
- 2026: 12 · 2025: 29 · 2024: 19 · 2023: 19 · 2022: 12 · 2021: 21 · 2020: 29 · 2019: 22 · 2018: 30 · 2017: 31 · 2016: 33 · 2015: 28 · 2014: 19 · 2013: 20 · 2012: 21
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- 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
- long-acting GLP-1 receptor agonists, type 2 diabetes, exenatide, liraglutide, glycemic control, weight loss, hypoglycemia, systolic blood pressure, nausea, incretin-based therapy, DPP-4 inhibitors, sulfonylureas, thiazolidinediones, beta-cell function
- MeSH terms
- Liraglutide, Exenatide, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Peptides, Venoms, Glucagon-Like Peptide 1
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