Current treatments and strategies for type 2 diabetes: Can we do better with GLP-1 receptor agonists?

Apr 26, 2012Annals of medicine

Current type 2 diabetes treatments: can GLP-1 receptor drugs improve care?

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Abstract

Reductions in glycated hemoglobin (A1C) of up to -1.6% have been reported among patients treated with GLP-1 receptor agonists.

Many individuals with type 2 diabetes do not achieve glycemic control with metformin alone.
Addition of other oral antidiabetes drugs is often necessary after metformin.
GLP-1 receptor agonists can provide significant reductions in A1C levels.
Weight loss ranging from -1.6 to -3.2 kg has been observed with GLP-1 receptor agonists.
Common adverse events include nausea and hypoglycemia when combined with sulfonylureas.

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Abstract Diet, lifestyle modification, and pharmacotherapy with metformin are appropriate initial treatments for many patients with type 2 diabetes (T2DM). However, most individuals do not maintain glycemic control with metformin alone. Addition of other oral antidiabetes drugs (OADs), including sulfonylurea, meglitinide, or thiazolidinedione, is often the next step. Newer options, including incretin-based glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors, offer important benefits as monotherapies or in combination with OADs, with low risk for hypoglycemia. Reductions in glycated hemoglobin (A1C) have been reported among patients treated with GLP-1 RAs (exenatide, -0.8 to -1.1%; liraglutide, -0.8 to -1.6%), as has weight loss (exenatide, -1.6 to -3.1 kg; liraglutide, -1.6 to -3.2 kg). GLP-1 RAs also stimulate β-cell responses and have positive effects on cardiovascular risk factors often present in patients with T2DM. The most common adverse events associated with GLP-1 RAs are nausea, which diminishes over time, and hypoglycemia (when used in combination with a sulfonylurea). A large number of trials demonstrated benefits of GLP-1 RAs, suggesting they could provide suitable treatment options for patients with T2DM.

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Current treatments and strategies for type 2 diabetes: Can we do better with GLP-1 receptor agonists?

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