Injecting New Ideas Into Managing Type 2 Diabetes: Evolving Roles of GLP-1 Receptor Agonists

Am J Med. 2025 Mar;138(3):e48. doi: 10.1016/j.amjmed.2019.02.001. Epub 2019 Feb 16.

Abstract

Type 2 diabetes is a progressive disease that often requires therapeutic intensification. Patients with type 2 diabetes frequently experience complications related to hyperglycemia, treatment-induced hypoglycemia, and comorbidities. Management of patients with type 2 diabetes is complicated and must be individualized, though guidelines from both the American Diabetes Association and the American Association of Clinical Endocrinologists/American College of Endocrinology provide treatment algorithms detailing therapeutic escalation with both oral and injectable therapies according to glycated hemoglobin (A1c) level. The development of injectable glucagon-like peptide-1 (GLP-1) receptor agonists has expanded management options and provided therapies that do not have some of the adverse events commonly associated with many other therapies used to treat type 2 diabetes. These incretin-based therapies, available in both daily and weekly formulations, have been shown to significantly reduce A1c levels, body weight, and cardiovascular risk factors. In this 4-part series, 2 expert physicians discuss clinical profiles of GLP-1 receptor agonists, strategies to reduce cardiovascular risk in type 2 diabetes, barriers to the use of injectable noninsulin therapies, and practical recommendations for noninsulin injectable therapies. These accredited educational programs are available online at https://glp1cme.elsevierresource.com/.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucagon-Like Peptide-1 Receptor
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / therapeutic use
  • Incretins* / therapeutic use

Substances

  • Glucagon-Like Peptide-1 Receptor Agonists
  • Hypoglycemic Agents
  • Glycated Hemoglobin
  • Incretins
  • Glucagon-Like Peptide-1 Receptor