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Understanding GLP-1 Medications for Diabetes and Obesity

Updated: May 9

GLP-1 medications are setting the stage for a new wave of weight loss drugs, but what are they, and how do they work?

Man taking photo of model

You may have already heard of GLP-1 agonists without realizing what they were, with a lot of media attention focused on so-called ‘celebrity’ weight loss drugs.

GLP-1 agonists are medications that not only help to reduce blood sugar levels but also promote weight loss by improving the communications system within the body, between cells and with the brain. There are a variety of different GLP-1 agonists, and they are just one part of an overall treatment plan for people with Type 2 diabetes or obesity.

What Are GLP-1 Agonists?

GLP-1 agonists are a class of medication initially designed or created to help people with Type 2 diabetes manage their blood sugar (glucose) levels. However, some GLP-1 agonists can also be used for the treatment of obesity.

Most GLP-1 agonists are injectables, with patients typically injecting themselves rather than visiting a GP for their injections due to the frequency of required injections. The injections are made just under the skin, in the fatty tissue. Some of the common injection locations include the belly, thighs, and backs of the arms.

GLP-1 agonists are also known as Glucagon-like peptide-1 agonists, GLP-1 receptor agonists, Incretin mimetics, and GLP-1 analogs.

For the most part, GLP-1 agonists are relatively new. The first GLP-1 agonist (Exenatide) was approved by the U.S. Food and Drug Administration (FDA) in 2005. Extensive research into GLP-1 agonists to discover their benefits and potential uses is ongoing. 

By themselves, GLP-1 agonists will not treat obesity or Type 2 diabetes. Both obesity and Type 2 diabetes require a variety of treatment strategies used in conjunction with one another, such as dietary and lifestyle changes, to be effective.

Common GLP-1 agonists include:

  • Dulaglutide (Trulicity®).

  • Exenatide (Byetta®).

  • Exenatide extended-release (Bydureon®).

  • Liraglutide (Victoza® and Saxenda®).

  • Lixisenatide (Adlyxin®).

  • Semaglutide injection (Ozempic® and Wegovy®).

  • Semaglutide tablets (Rybelsus®).

  • Tirzepatide (Mounjaro® and Zepbound®)

Some common GLP-1 agonists

How Do GLP-1 Agonists Work?

To better understand how GLP-1 agonists work, it helps to understand how the GLP-1 hormone works and what role it plays in the body.

GLP-1 is a hormone produced in your small intestine. Some of its roles include:

  • Triggering Insulin Release from Your Pancreas – Insulin is a hormone that allows your body to process the food you eat and turn it into energy while lowering the amount of glucose or sugar in your blood. Without enough insulin, your blood sugar increases, which leads to diabetes.

  • Block Glucagon Secretion – Glucagon is a hormone used by the body to raise blood sugar levels when required. GLP-1 prevents additional glucose from entering your bloodstream.

  • Slow Down Stomach Emptying – When your digestion slows, so does the amount of glucose the body releases into your bloodstream.

  • Increase How Full You Feel After Eating – GLP-1 affects the areas of your brain that control hunger and how full you feel.

GLP-1 agonist medications, such as those listed above, work by mimicking the natural GLP-1 hormone. An agonist is a medical term for a substance that mimics the same actions as a naturally occurring substance. 

If you have Type 2 diabetes, GLP-1 agonists help you manage your blood sugar levels by triggering your pancreas to release increased amounts of insulin. By slowing your digestion, GLP-1 agonists also help to reduce spikes in blood sugar. By making you feel fuller (satisfied), GLP-1 agonists reduce how much food you eat, your cravings, and your appetite. The combined effects of this often result in weight loss.

Why Would You Need to Take A GLP-1 Agonist?

General practitioners (GPs) or healthcare providers prescribe GLP-1 agonists for two conditions: Obesity and Type 2 diabetes.

GLP-1 Agonists for Type 2 Diabetes 

The FDA has approved GLP-1 agonists to help manage T2D (Type 2 diabetes), thanks to the effects of GLP-1 agonists on lowering blood sugar levels.

Oral medication Metformin

Along with GLP-1 agonists, there are also several other diabetes medications, including oral medications. One oral medication, metformin, is a common treatment for T2D. However, a healthcare provider may prescribe a GLP-1 agonist if metformin isn’t working, you have a contradiction to taking metformin, your A1C is higher than your target, or you haven’t reached your A1C target within 3 months of treatment beginning.

It’s important to note that the most effective way to manage your T2D is a combination of therapies, including lifestyle and diet changes, exercise, and medication.

Although GLP-1 agonists are not approved by the FDA for the treatment of Type 1 diabetes (T1D), researchers are studying the safety and effectiveness of GLP-1 agonists for people diagnosed with T1D.

GLP-1 Agonists for Obesity 

Currently, the FDA has approved Semaglutide, Tirzepatide, and high-dose Liraglutide for the treatment of obesity thanks to these GLP-1 agonist’s effects on weight loss. 

Obesity is a chronic condition in which your body mass index (BMI) is 30 or above. To learn more about obesity, check out Breaking Down Obesity: Understanding Its Effects and Navigating Treatment Options!

BMI Chart

Some healthcare professionals may also prescribe Semaglutide, Tirzepatide or a high-dose Liraglutide for people who are overweight. Being overweight is defined as having a BMI between 25-29.9. GPs with patients in this category may recommend GLP-1 solutions when the patient has one or more additional comorbidities, including high blood pressure (HBP), high cholesterol, fatty liver disease, or a number of other complications. 

In addition to medical intervention, there are a variety of treatments and effective management therapies for obesity, including exercise, dietary changes, medication, behavioral modification, and weight loss surgeries. 

GLP-1 Agonist Treatment FAQs 

How often will you need to take GLP-1 agonists? Your healthcare provider will give you your injection schedule, but typically, they are either daily or weekly.

What are the potential benefits of GLP-1 agonists? As well as lowering blood sugar levels and weight loss, GLP-1 agonists can also assist with lowering blood pressure, improving lipid disorders, improving fatty liver disease, reducing your risk of heart and kidney disease, and delaying the progression of diabetes-related neuropathy. 

What are some of the side effects of GLP-1 agonists? The most common side effects of GLP-1 agonists include loss of appetite, nausea, vomiting, and diarrhea. These side effects are more common when you start with a high-dose GLP-1 agonist. Other less common side effects include dizziness, increased heart rate, infections, headaches, and indigestion. Severe but rare side effects include pancreatitis, medullary thyroid cancer, acute kidney injury, and worsening diabetes-related retinopathy.

What are the risks or complications associated with GLP-1 agonists? Most GLP-1 agonists are considered generally safe, but there are some risks to consider, including allergic reactions, use during pregnancy, and low blood sugar. GLP-1 agonists are still relatively new to the market, so future studies are required and additional complications may emerge over time.

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