GLP-1 receptor agonists for diabetes: a review of the cardiovascular, kidney and mortality outcomes

This study investigated the effects of glucagon-like peptide 1 receptor agonists (GLP-1Ra) in patients with diabetes. 

They found that GLP-1Ra drugs improved cardiovascular (CV), kidney and mortality outcomes. 

Type 2 diabetes (T2D) is caused by a reduced response to insulin. This is called insulin resistance (IR). IR makes it difficult to control blood glucose levels. Patients with T2D take drugs to regulate blood glucose (glycemia). Achieving glycemic control (GC) can be difficult. In recent years, new drug targets have been identified for T2D patients.

Glucagon-like peptide 1 receptor agonists (GLP-1Ra) are a new type of anti-diabetic drug. They act on GLP-1 receptors to release insulin. They also lower the levels of a hormone called glucagon. Glucagon increases blood glucose. GLP-1Ra drugs have a relatively long duration of action compared to other anti-diabetic drugs. Some studies suggest this might have an effect on cardiovascular (CV) safety. The effect of GLP-1Ra on CV outcomes is unclear.  

This study included 7 clinical reports of patients with T2D. 56,004 patients took part in these studies. The GLP-1Ra drugs used included lixisenatide (Lyxumia), liraglutide (Victoza), semaglutide (Ozempic), exenatide (Byetta), albiglutide (Tanzeum), and dulaglutide (Trulicity). Patients received either a GLP-1Ra or a placebo (inactive drug). The main outcome was the occurrence of major adverse cardiac events (MACE). These included stroke, heart attack or CV-related death. 

GLP-1Ra treatment was associated with a significant 12% reduction in MACE. The effect of GLP-1Ra was similar regardless of blood glucose levels at the beginning of the study. The risk of death from any cause was reduced by 12%. The rate of kidney disease was 17% lower in GLP-1Ra-treated patients.

The rates of severe hypoglycemia (dangerously low blood glucose levels), pancreatic cancer and pancreatitis (inflammation in the pancreas) were not significantly different between the groups.

The authors concluded that GLP-1Ra drugs improved CV, kidney and mortality outcomes in patients with T2D.

This was a retrospective study meaning it looked back at medical records. Some patient-level data was not available. Eye examinations were not reported in all the studies. More investigation is needed.

If you have any concerns regarding diabetes please discuss this with your physician.