GLP-1 receptor agonists

Injectable agents structurally similar to endogenous GLP-1.

Activate GLP-1 receptors in many issues, that may delay gastric emptying, promote appetite suppression, and typically result in weight loss approximately 2-4 kg.

Include exenatide, albiglutide and dulaglutide, and liraglutide.

Stabilize post meal glucagon and help return blood glucose to normal.

Effects on receptors include increased satiety, decreased gastric emptying, increase glucose uptake by muscle and adipose tissue, decreased glucose production by the liver, and increase insulin secretion.

The effect of GLP-1 on insulin secretion is glucose dependent, and therefore does not lead to hypoglycemia if glucose levels are low.

Once released, GLP-1 is metabolized by dipepidyl peptidase 4 (DPP-4) shortly thereafter.

GLP-1 analogues are ideal message of glycemic controlling combat many of the negative consequences of type two diabetes.

Decrease his hemoglobin A-1 C levels by 0.3%-1.4%, reduce body fat, and induces a small reduction in blood pressure and increase in heart rate.

These agents typically do not cause hypoglycemia, although caution is taken in the setting of multiple glucose lowering therapies.

Gastrointestinal side effects are common.

Some patients cannot tolerate these agents.

All GLP-1receptor agonists are peptides that require subcutaneous injection.

In the LEADER study, 2242metformin GLP1RA agents should be added In obese patients because of the potential to promote weight loss.

It is now recommended by the ADA to be the first injectable agent prior to the use of insulin.

In the PIONEER 3 trial Semaglutide, the first oral preparation of a GLP-1RA, resulting in greater glucose lowering and weight loss compared with sitagliptin.

The mechanism of which GLP-1 RAs affect cardiovascular disease or more variable in those with SGLT2 inhibitors.

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