Glucagon-Like Peptide-1 Receptor Analogues in Type 2 Diabetes: Their Use and Differential Features.
Clin Drug Investig · 2019
Last updated 2026-05-28
GLP-1 receptor agonists (GLP-1RAs) are injectable medications used alongside diet and lifestyle changes to treat type 2 diabetes, either alone or with other diabetes drugs like insulin. They work by increasing insulin and lowering blood sugar in a way that depends on glucose levels, helping improve blood sugar control and weight while generally being well-tolerated. The most common side effects are mild stomach issues or reactions at the injection site, and they carry a very low risk of causing dangerously low blood sugar. These medications come in different forms, including twice-daily, daily, and weekly injections, and can be tailored to fit individual needs.
Glucagon-like peptide-1 receptor analogues/agonists (GLP-1RAs) are well established as effective adjuncts to lifestyle modification in the treatment of type 2 diabetes (T2D) as monotherapy or in combination with oral glucose-lowering drugs ± insulin. The six subcutaneous GLP-1RA formulations (i.e. twice-daily exenatide, once-daily liraglutide and lixisenatide, and once-weekly dulaglutide, exenatide and semaglutide) currently available in the EU and USA have many similarities, but also some unique features and properties. By stimulating GLP-1 receptors, GLP-1RAs increase insulin secretion and suppress glucagon release in a glucose-dependent manner, thereby improving clinical and patient-reported outcomes related to glycaemic control and weight. They also have been shown to reduce, or at least not increase, the risk of major cardiovascular outcomes. GLP-1RAs are generally well tolerated, with gastrointestinal and injection-site reactions being the most troublesome drug-related adverse events, and are associated with a very low intrinsic risk of hypoglycaemia. Treatment with GLP-1RAs should be customized to meet the clinical needs and personal preferences of the individual.
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