A Plethora of GLP-1 Agonists: Decisions About What to Use and When

Curr Diab Rep. 2016 Dec;16(12):120. doi: 10.1007/s11892-016-0823-6.

Abstract

Incretin-based therapies are important addition to our armamentarium for the treatment of type 2 diabetes (T2DM). There are six Glucagon-like peptide-1 receptor agonists (GLP-1RAs) which have received regulatory approval for clinical use. The short-acting GLP-1RAs include exenatide twice daily, liraglutide once daily, and lixisenatide once daily. The approved long-acting GLP-1RAs are administered weekly and are exenatide, albiglutide, and dulaglutide. Although all of these therapies lower hemoglobin A1C (HbA1C), there also are unique features of GLP-1RAs that have been made manifest from clinical trial data with regard to weight-loss efficacy, fasting and post-prandial glucose control, cardiovascular safety and protection, and gastrointestinal and injection adverse effects. It is imperative to consider these features when tailoring the choice of a GLP-1RA to patient specific characteristics.

Keywords: Diabetes prevention; Impaired fasting glucose; Impaired glucose tolerance; Obesity; Pre-diabetes; Type 2 diabetes; Weight loss.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Exenatide
  • Glucagon-Like Peptide-1 Receptor* / agonists
  • Glucagon-Like Peptides / analogs & derivatives
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Immunoglobulin Fc Fragments / adverse effects
  • Immunoglobulin Fc Fragments / therapeutic use
  • Liraglutide / adverse effects
  • Liraglutide / therapeutic use
  • Peptides / adverse effects
  • Peptides / therapeutic use
  • Recombinant Fusion Proteins / adverse effects
  • Recombinant Fusion Proteins / therapeutic use
  • Venoms / adverse effects
  • Venoms / therapeutic use

Substances

  • dulaglutide
  • Exenatide
  • Glucagon-Like Peptides
  • Glycated Hemoglobin
  • hemoglobin A1c protein, human
  • Hypoglycemic Agents
  • Immunoglobulin Fc Fragments
  • Liraglutide
  • Peptides
  • Recombinant Fusion Proteins
  • Venoms
  • Glucagon-Like Peptide-1 Receptor