Photo Credit: by Judy Conwell, flickr.com
A drug for diabetes that is changing the landscape of chronic disease management? Tell you more? Why, certainly! So, what are GLP-1 receptor agonists? These medications tell the pancreas to make insulin (which brings down our blood sugar), slow down your stomach’s ability to empty digested food into your intestines (thereby making you fuller, faster), and reduce the amount of food you eat. Hence, it’s no secret why these medications, such as Rybelsus, were made to treat Type 2 Diabetes. However, it is also no secret that these medications have gained immense popularity for weight loss due to their ability to reduce overall food intake by making you feel fuller quicker. The two FDA-approved GLP-1 medications for weight loss are Wegovy and Zepbound. As we will see, though, these medications are being found to be more versatile than previously thought.
Heart Strong: Cardiovascular Benefits of GLP-1 Medications
A game changer for heart disease, too? That’s right, these medications can help your heart! As Type 2 Diabetes worsens, it has negative effects on many parts of the body, including the heart. This has spurred research into medications that can treat not only diabetes itself but also its downstream effects on other organs. Therefore, the medical community was beside itself when GLP-1 medications could protect the heart, too! Multiple studies have found that specific GLP-1 medications can reduce the risk of plaque buildup in our arteries, stroke, and dying from heart disease in people who also have Type 2 Diabetes. Specifically, the SUSTAIN-6 Trial found that in those with Type 2 Diabetes and who were also at high risk of heart disease, those taking Semaglutide had a much lower rate of dying from heart disease, heart attack, and stroke compared to those taking a placebo. Therefore, if you have type 2 diabetes, speak to your doctor about your risk for heart disease and whether you may benefit from a GLP-1 medication.
Kidney Keepers: Protecting Kidney Function Through Metabolic Control
As if the heart were not enough, you guessed it, GLP-1 medications protect your kidneys, too! Just as much as it can damage the heart, progressive worsening of diabetes can affect our kidneys, too. Thus, research began into whether any medications can protect the kidneys as well, and there again were our GLP-1 medications. Multiple studies have found that GLP-1 medications reduce the incidence of kidney failure, reduce kidney function, and reduce the risk of dying from kidney disease in those who have both Type 2 Diabetes and Chronic Kidney Disease. Most notably, the FLOW Trial found an overall reduction in the risk of serious kidney problems, like kidney failure, major drops in kidney function, or death from kidney or heart disease in those with Type 2 Diabetes and Chronic Kidney disease taking semaglutide compared to placebo. It has been astounding how many applications the GLP-1 medications have, as more and more studies are finding benefits in various diseases.
Brain Boosters and More: The Surprising Reach of GLP-1s
Can these GLP-1 medications have protective effects on the brain, too? The answer is still pending, so to speak. There has been growing research into the role of insulin resistance, or the body not responding appropriately to insulin as it should, within the brain as well – something researchers have termed Type 3 Diabetes. Thus, research has begun into potential mechanisms by which GLP-1 medications may also affect the brain. Notably, studies are showing a potential application of GLP-1 medications in protecting the brain from neurodegenerative conditions such as Alzheimer’s Disease. While research is ongoing, the GLP-1 medications may be able to block the buildup of abnormal proteins in the brain implicated in these conditions. As noted above, further research is needed, such as large-scale trials that have found heart and kidney protective effects. Nevertheless, the potential for these medications to have a future role in protecting the brain from these conditions is staggering enough to motivate researchers to carry on in their work.
Risks & Side Effects: Balancing the Benefits
It is just as important to be informed about the potential risks and side effects of taking GLP-1 medications, like with any therapeutic. The most common side effects are gastrointestinal, including nausea, vomiting, and diarrhea. When used for weight loss, even more severe side effects have been found, such as intestinal obstruction and symptomatic gastroparesis (slowing the stomach’s ability to empty digested food into the intestines with enough delay to cause symptoms such as nausea and vomiting). Other severe side effects noted with the use of GLP-1 medications include acute pancreatitis, an inflammation of the pancreas associated with severe abdominal pain that requires hospitalization. GLP-1 medications have also been noted to cause acute cholecystitis, or inflammation of the gallbladder, which also requires hospitalization and surgery to remove the gallbladder. This and other severe side effects not noted here often require the medication to be stopped indefinitely. Therefore, when considering these medications, it is of utmost importance to only begin such medications at the direction of your doctor, who can explain the risks and benefits of taking GLP-1 medications.
Final Thoughts: GLP-1s and the Future of Chronic Disease Care
It is no secret that you’re now wondering how many applications these medications may have in chronic diseases. From your heart to your brain, the applications seem limitless. Thankfully, research is ongoing, so stay tuned for further developments surrounding these medications. It is important to note that if and when you speak to your doctor about GLP-1 medications and if they’re right for you, they may not be. Medicine is not one size fits all, and only your doctor knows which medications are right for you based on risks and benefits. Nonetheless, it is important to stay informed, speak to your doctor if these medications are right for you, and take them only as directed. The sky’s the limit for GLP-1 medications, and the future seems brighter.
Reference:
https://www.uptodate.com/contents/glucagon-like-peptide-1-based-therapies-for-the-treatment-of-type-2-diabetes-mellitus?search=glp-1&usage_type=default&source=search_result&selectedTitle=2%7E150&display_rank=1#H865633
https://www.nejm.org/doi/full/10.1056/NEJMoa1607141
https://www.uspharmacist.com/article/the-emerging-role-of-glp1-ras-in-parkinsons-disease#:~:text=Preclinical%20animal%20studies%20suggest%20that,denervation%2C%20and%20improve%20motor%20function.
https://medicalxpress.com/news/2025-01-glp-medications-diabetes-weight-loss.html
https://www.thetimes.com/uk/healthcare/article/alarm-raised-over-mounjaro-wegovy-weight-loss-jab-side-effects-l328qwlf3?region=global
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