The Dual Role of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1s) in Diabetes and Weight Management?


 2024-07-08

Type 2 diabetes affects tens of millions of people and makes it difficult to manage weight. This is why receiving effective treatment is crucial. Glucagon-like peptide-1 receptor agonists (GLP-1s) —such as Mounjaro, Ozempic, and Trulicty—are a class of medications that are revolutionizing type 2 diabetes therapy and weight control.

GLP-1s have been well-publicized for their substantial weight-loss advantages, which have contributed to their rise in popularity. Even celebrities and influencers have touted their effectiveness, creating a buzz around these medications.

Their dual benefits of weight loss and diabetes management make GLP-1s attractive to a broad audience.

What is Glucagon-Like-Peptide 1?

Glucagon-like-peptide 1 is produced in the intestines—mostly in reaction to food.

Glucagon-like-peptide 1 is essential for the body’s ability to regulate blood-sugar levels and aid in digestion. It does so by:

  • Stimulating Insulin Release: After a meal, glucagon-like-peptide 1 stimulates the pancreas to release insulin, which lowers blood sugar levels.
  • Inhibiting Glucagon Release: Glucagon-like-peptide 1 suppresses the release of glucagon, a hormone that raises blood sugar levels by prompting the liver to release stored glucose.
  • Slowing Gastric Emptying: Glucagon-like-peptide 1 causes the stomach to empty more slowly, which results in a longer sensation of fullness and a more progressive absorption of nutrients.
  • Reducing Appetite: By influencing the brain’s hunger centers, glucagon-like-peptide 1 helps decrease appetite and promote fullness.
  • Promoting Beta-Cell Health: Glucagon-like-peptide 1 supports the health and function of the insulin-producing beta cells in the pancreas.

What Are GLP-1 Medications?

GLP-1 medications act like “helpers” for glucagon-like-peptide 1.

GLP-1s mimic glucagon-like-peptide 1—meaning, they copy what glucagon-like-peptide 1 does naturally.

By doing so, GLP1s help people—especially people with type 2 diabetes—manage their blood sugar and stay healthier.

GLP-1s are often prescribed when diet, exercise, and other diabetes medications are not enough to keep blood-sugar levels in check.

GLP-1s include the following:

Due to their effectiveness and versatility, GLP-1 medications have become a popular choice for managing weight and diabetes.

How Do GLP-1s Work?

To restate:

  • Your small intestine naturally produces the hormone GLP-1.
  • GLP-1s are made to “mimic” the way that GLP-1 acts.

Unlike insulin or sulfonylureas—which directly increase insulin levels—GLP-1s offer a more balanced approach by enhancing the body’s natural regulatory mechanisms.

  • GLP-1s are released in response to food intake, stimulating insulin secretion from the pancreas while inhibiting glucagon release.
    • This helps lower blood-sugar levels by enhancing the body’s natural insulin response and slowing down digestion.
  • GLP-1s also slow gastric emptying and promote a feeling of fullness, aiding in weight management.

Many people find GLP-1s convenient as they can be administered with weekly injections, making it easier to stick to the treatment plan.

Plus, the benefits of GLP-1s extend beyond diabetes management, as they are shown to improve cardiovascular health, which is a big plus for overall wellness.

What Are the ‘Dual Benefits’ of GLP-1s on Diabetes and Weight Loss?

GLP-1s offer dual benefits in diabetes and weight management, making them a powerful tool in treating type 2 diabetes.

Diabetes Management

For diabetes management, GLP-1s have been proven to:

GLP-1s are also highly effective in lowering A1c levels in people with type 2 diabetes.

Mounjaro

  • The SURPASS-1 Trial evaluated Mounjaro in patients with type 2 diabetes inadequately controlled with diet and exercise alone.
  • Results demonstrated that Mounjaro significantly reduced A1c levels by up to 2.07 percentage points over 40 weeks at the highest dose of 15 mg.​

Ozempic

Trulicity

On average, patients saw a decrease of about 1.1 to 1.4 percentage points compared to baseline measurements, depending on the duration and population studied​.

Weight Management

There are hundreds of peer-reviewed clinical studies that provide strong support for the use of GLP-1s in diabetes and weight management. These findings underscore why GLP-1s are so popular and trusted in current medical practice.

Mounjaro

  • The SURPASS-2 trial demonstrated that Mounjaro is highly efrfective for managing blood-sugar levels and weight in people with type 2 diabetes.

Ozempic

  • In the STEP (Semaglutide Treatment Effect in People with Obesity) program, Ozempic 2.4 mg once weekly resulted in an average weight loss of 14.9% over 68 weeks in adults with obesity or overweight, with 86% of participants achieving at least 5% weight loss​.

Victoza

  • Victoza 3.0 mg was found to significantly outperform placebo in the SCALE Obesity and Prediabetes trial, resulting in an average weight loss of 8% over 56 weeks.
    • In the extension research, Victozxa also assisted patients in maintaining their weight loss for a maximum of three years.

Trulicity

How Are GLP-1s Given?

GLP-1s are typically administered through injections, either under the skin or into a muscle.

Depending on the brand, GLP-1 injections are usually given once a day or once a week, depending on the specific medication. For example:

  • Mounjaro (taken weekly)
  • Ozempic (taken weekly)
  • Rybelsus (taken by mouth once daily)
  • Wegovy (taken weekly)
  • Trulicity (taken weekly)
  • Victoza (taken daily)

Unlike insulin, which often needs to be injected multiple times a day, GLP-1s offer a more convenient dosing schedule.

Some GLP-1 medications are available in pen devices that make self-administration straightforward.

What Are the Side Effects of GLP-1s?

GLP-1s  are effective for managing type 2 diabetes, but like any medication, they can have side effects, including:

  • Nausea: Some people experience mild nausea, especially when starting GLP-1s.
  • Vomiting: Rarely, vomiting may occur.
  • Pancreatitis: Although rare, it’s essential to monitor for signs of pancreatitis.
  • Hypoglycemia: GLP-1s can lower blood sugar, leading to hypoglycemia.
  • Weight Loss: While beneficial, unintended weight loss can occur.
  • Injection Site Reactions: Redness or discomfort at the injection site is possible.

Embracing the Future of Diabetes Management with GLP-1s

  • GLP-1s have the potential to revolutionize diabetes treatment due to their multifaceted benefits.
  • GLP-1s not only significantly lower A1c levels and enhance blood-sugar control, but also promote substantial weight loss—addressing two critical aspects of diabetes management​.
  • GLP-1s have also been shown to reduce the risk of major cardiovascular events, offering additional protection for patients with type 2 diabetes, who are at heightened risk for heart disease​.
  • GLP-1s improve insulin secretion, suppress appetite, and delay gastric emptying. All of this positions GLP-1s as a promising therapeutic option that can improve overall metabolic health and quality of life for many people with type 2 diabetes.

Make sure you talk to your doctor before beginning any type 2 diabetes medication or following any weight-management plan.

WRITTEN BY Daniel Trecroci, POSTED 07/08/24, UPDATED 07/08/24

Dan has written about diabetes for more than 20 years. He was one of Diabetes Health's first recruits, and throughout his 10 + years as Managing Editor he wrote/published thousands of articles and helped establish Diabetes Health as the premiere resource for people with diabetes. He later became the Content Manager for OneTouchGold—Johnson & Johnson/LifeScan’s official digital publication for its metering-technology customers. Under his leadership, OneTouchGold received the Web Marketing Association’s award for “Best Health & Wellness" web site. Dan has also written for the Diabetes Research Institute, dLife, diaTribe, Healthline, CareDx, Pendulum Therapeutics, and Hero Bread.