How effective are once weekly GLP-1 receptor agonists for the treatment of type 2 diabetes?

This review examined the safety and effectiveness of once weekly GLP-1 receptor agonists for the treatment of type 2 diabetes. The authors concluded that once weekly  GLP-1 RA drugs are convenient, safe and effective for the treatment of type 2 diabetes.

Patients with type 2 diabetes (T2D) initially produce insulin (hormone which lowers blood sugar levels) but it fails to work in the body. Drugs such as metformin (Glucophage) aim to help insulin work in the body. However, eventually the pancreas reduces insulin production. Patients may need to be treated with a long-acting insulin such as glargine (Lantus).

Drugs such as sitagliptin (Januvia) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) increase insulin secretion. GLP-1 RA drugs may be short-acting or long-acting. Exenatide BID (Byetta) twice daily is a short-acting GLP-1 RA. GLP1-RA drugs which are long-acting are administered once weekly and include albiglutide (Tanzeum) and dulaglutide (Trulicity). GLP1-RA drugs are generally used in combination with other anti-diabetic agents such as metformin or insulin.

This review summarized results from 33 clinical trials which investigated the safety and effectiveness of once weekly GLP-1 RA drugs. A total of 16,003 participants were included in the clinical trials. The trials compared once weekly GLP-1 RA drugs to a placebo (substance with no therapeutic effect) or to other anti-diabetic drugs.

The HbA1c (average blood glucose levels over 3 months) decreased more in participants treated with dulaglutide (-1.18%) compared to albiglutide (-0.66%). Neither albiglutide nor dulaglutide treatment promoted weight loss.

Once weekly GLP-1 RA drugs resulted in a greater reduction in HbA1c (average reduction of 0.4%) compared to sitagliptin. In comparison to daily exenatide, once weekly treatment with a GLP-1 RA resulted in a greater reduction in HbA1c (average reduction of 0.44%). In comparison to insulin glargine, once weekly treatment with GLP-1 RA resulted in a greater reduction in HbA1c (average reduction of 0.28%).

The main side effects occurring with GLP-1 RA treatment included gastrointestinal reactions and reactions at the injection site.

This review concluded that once weekly GLP-1 RA drugs are a convenient, safe and effective option for the treatment of T2D.

Consult your physician regarding the risks and benefits of GLP-1 RA drugs.