Anti‐diabetic effects of GLP ‐1 receptor agonists on obese and overweight patients across diabetes status, administration routes, treatment duration and baseline characteristics: A systematic review

🥉 Top 5% JournalDec 27, 2024Diabetes, obesity & metabolism

Anti-diabetic effects of GLP-1 receptor drugs in overweight and obese patients, considering diabetes status, how the drugs are given, treatment length, and patient traits: A systematic review

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Abstract

GLP-1 receptor agonists resulted in a 0.72% reduction in glycated hemoglobin (HbA1c) and a 1.00 mmol/L reduction in fasting plasma glucose (FPG).

GLP-1 receptor agonists may be effective for weight management in adults with and without type 2 diabetes.
A reduction in HbA1c of -0.44% was observed in patients with pre-diabetes.
Patients followed for more than a year experienced a smaller reduction in HbA1c.
The efficacy of GLP-1 receptor agonists may be greater at higher HbA1c levels and lower body mass index.
These findings could suggest potential new uses for GLP-1 receptor agonists in managing obesity and pre-diabetes.

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Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for anti-obesity indications. However, little is known of the comparative effect of GLP-1 RAs and their glycemic impact across the different routes of administration, diabetic statuses and durations of prescription. PubMed, EMBASE and CENTRAL were searched from inception to 13 February 2024. Only randomised controlled trials were included in this systematic review and meta-analysis. Adults aged above 18 years old, who were in the overweight/obesity range, with or without type 2 diabetes mellitus (T2DM) were included. Baseline characteristics and changes in glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) were obtained. GLP1-RAs demonstrated an overall reduction in HbA1c of -0.72% (95% confidence interval [CI] -0.79 to -0.65, p < 0.01) and in FPG of -1.00 mmol/L (95% CI -1.16 to -0.84, p < 0.01). HbA1c reduction in pre-DM patients was -0.44% (95% CI -0.54 to -0.18, p < 0.01). Patients who were followed up for more than a year experienced a smaller reduction of HbA1c. Meta-regression showed that the GLP-1 RAs are more efficacious at higher HbA1c and lower body mass index. Overall, GLP-1 RAs consistently led to a significant reduction in HbA1c at -0.72% and FPG at -1.00 mmol/L. These effects may be equally efficacious in pre-DM patients with obesity and those at lower BMI. With pre-DM and obesity being risk factors for metabolic syndrome, these findings may provide newer perspectives in expanding indications for GLP-1 RA initiation.

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