Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are injectable medicines that deal with kind 2 diabetes.
Just like insulin, they’re injected beneath the pores and skin. GLP-1 RAs are mostly used collectively with different antidiabetes remedies.
At the moment, there are a number of GLP-1 RAs in the marketplace that differ by dosing schedule and period of motion. They embody:
- exenatide (Byetta)
- exenatide — prolonged launch (Bydureon)
- dulaglutide (Trulicity)
- semaglutide (Ozempic) — additionally accessible in pill kind (Rybelsus)
- liraglutide (Victoza)
- lixisenatide (Adlyxin)
Pramlintide (Symlin) is one other injectable drug authorised for remedy of kind 2 diabetes. It’s used along side mealtime insulin pictures. Although much less generally used, it really works equally to GLP-1 RAs.
Not like insulin and different antidiabetic medication, injectables don’t trigger weight acquire.
As a result of they lower urge for food, they could even contribute to weight reduction within the vary of three.3 kilos (1.5 kg) to six.6 kilos (3 kg). The quantity of weight reduction depends upon a number of components, reminiscent of:
- eating regimen
- use of different medicines
Due to this, GLP-1 RAs are properly suited to people who find themselves obese or have weight problems. They’re typically utilized in mixture with different medication or insulin to mitigate weight acquire.
GLP-1 RAs can be found in prefilled pens that you just administer your self, in a lot the identical manner as insulin. They differ by dosage and period of motion.
There are presently no comparative trials that present how alternative of treatment impacts long-term affected person outcomes.
Your physician will normally begin you off with a low dosage. This shall be step by step elevated based on tolerance and desired impact.
Byetta is the one agent that must be administered twice a day. The others are every day or weekly injections.
Gastrointestinal unwanted effects, reminiscent of nausea, vomiting, and diarrhea, happen in lots of sufferers. Nausea could reduce over time or by decreasing the dose. It might additionally happen much less steadily with weekly brokers.
Some studies hyperlink acute pancreatitis with GLP-1 RAs, however there’s not sufficient knowledge to ascertain a transparent causal relationship. Analysis has explored different potential opposed results on the pancreas, reminiscent of pancreatic most cancers, however inadequate proof exists.
Some GLP-1 RAs could trigger native pores and skin reactions on the injection web site. Some folks utilizing exenatide (Bydureon, Byetta) have reported this facet impact.
Hypoglycemia not often happens with GLP-1 RAs when used alone. Nevertheless, including them to insulin-based therapies can enhance threat.
In rodent research, there was a rise in medullary thyroid tumors. An analogous impact has not but been present in people.
Life-style modifications for folks with kind 2 diabetes could encompass:
- modifying eating regimen
- shedding 5 to 10 p.c of physique weight, for individuals who have obese or weight problems
- repeatedly exercising for 150 minutes every week
- self-monitoring of blood sugars
- limiting alcohol to at least one drink per day for grownup ladies and two drinks per day for grownup males
- not smoking or quitting smoking
The diabetes plate method is often used for offering fundamental meal planning steering and for its visible assist.
Seeing a registered dietitian may additionally assist lead you to a more healthy eating regimen. A dietitian can advocate an individualized vitamin plan that accounts in your particular components and preferences.
Generally, decreasing your carbohydrate consumption is critical to enhance blood sugar administration.
Select carbs which can be:
- excessive in fiber
- minimally processed
Substitute sugar-sweetened drinks with water.
Moreover, consuming meals wealthy in monounsaturated and polyunsaturated fat may enhance glucose metabolism and decrease cardiovascular threat.
Injectable GLP-1 RAs and pramlintide (Symlin) are costly. No generic choices are presently accessible. Common wholesale costs are as follows:
- Exenatide: $840
- Dulaglutide: $911
- Semaglutide: $927
- Liraglutide: $1,106
- Lixisenatide: $744
- Pramlintide: $2,623
These are lined by many insurance policy. however coverage tips, exclusions, necessities for step remedy, and prior authorization differ extensively.
It’s vital to change into accustomed to the specifics of your prescription drug plan.
Dr. Maria S. Prelipcean is a doctor specializing in endocrinology and diabetes. She presently works at Southview Medical Group in Birmingham, Alabama. Dr. Prelipcean is a graduate of Carol Davila Medical Faculty in Bucharest, Romania. She accomplished her inner medication coaching on the College of Illinois and Northwestern College in Chicago and her endocrinology coaching on the College of Alabama in Birmingham. Dr. Prelipcean has been repeatedly named as a Birmingham Prime Physician and is a Fellow of the American Faculty of Endocrinology. In her spare time, she enjoys studying, touring, and spending time together with her household.