Existing and emerging GLP-1 receptor agonist therapy: Ramifications for diabetic retinopathy screening

J R Coll Physicians Edinb. 2024 Jun;54(2):170-173. doi: 10.1177/14782715241244843. Epub 2024 Apr 5.

Abstract

GLP-1 receptor agonist treatment revolutionised the management of type 2 diabetes mellitus with significant enhancement of cardiovascular risk reduction. They have been instrumental in effectively managing the glycaemic control of this at-risk patient group. This class of drugs are associated with rapid improvement in glucose levels and consequently, transient early worsening of pre-existing diabetic retinopathy (DR) which is well-recognised, but this paradox is less commonly perceived in routine clinical practice. The recent shortage of supply has resulted in an enforced hiatus to prescribing all existing GLP-1 receptor agonists, which is expected to last all through 2024. This becomes even more pertinent as their DR could have progressed due to worsening HbA1c as a result of the unforeseen interruption to GLP-1 receptor agonist treatment. Therefore, when these medications are recommenced in a few months' time, all prescribers need to be aware of these patients' most up-to-date DR status and liaise with their affiliated screening service.

Keywords: GLP-1 receptor agonist shortage; diabetic retinopathy; rapid HbA1c improvement; retinal screening.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Exenatide / therapeutic use
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glucagon-Like Peptides / analogs & derivatives
  • Glucagon-Like Peptides / therapeutic use
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Immunoglobulin Fc Fragments / therapeutic use
  • Liraglutide / therapeutic use
  • Mass Screening / methods
  • Recombinant Fusion Proteins

Substances

  • Hypoglycemic Agents
  • Glycated Hemoglobin
  • Glucagon-Like Peptides
  • Exenatide
  • Immunoglobulin Fc Fragments
  • dulaglutide
  • Liraglutide
  • Recombinant Fusion Proteins
  • Glucagon-Like Peptide-1 Receptor Agonists