There is a group of medications for type 2 diabetes known as glucagon-like peptide 1 (GLP-1) agonists that not only enhance blood sugar regulation but can also result in weight loss. The extent of weight loss may differ depending on the specific GLP-1 medication and the dosage used.
GLP-1 agonists are typically administered via injection, either daily or weekly; as of the day of this article, only Saxenda is approved for the use in weight control in Hong Kong:
– Dulaglutide (Trulicity) (weekly)
– Exenatide extended-release (Bydureon BCise) (weekly)
– Exenatide (Byetta) (twice daily)
– Semaglutide (Ozempic) (weekly)
– Liraglutide (Saxenda) (daily)
– Lixisenatide (Adlyxin) (daily)
– Semaglutide (Rybelsus) (oral, once daily)
These drugs function by mimicking the effects of the hormone glucagon-like peptide 1. When blood sugar levels rise after eating, GLP-1 drugs stimulate the body to produce more insulin, which helps lower blood sugar levels. Although it’s unclear how GLP-1 drugs contribute to weight loss, they are known to suppress appetite and slow down the movement of food from the stomach to the small intestine, making individuals feel fuller for longer.
In addition to aiding in blood sugar control and weight loss, GLP-1s may offer other significant benefits, such as reducing the risk of heart disease, heart failure, stroke, and kidney disease. These drugs have also been associated with improvements in blood pressure and cholesterol levels, although it’s uncertain if these benefits are directly due to the medication or the resulting weight loss.
However, all GLP-1 drugs, except for one, must be taken via injection, and like all medications, they carry the risk of side effects, some of which can be serious. Common side effects include nausea, vomiting, and diarrhea. A more serious risk associated with GLP-1 drugs is low blood sugar levels (hypoglycemia), particularly when taken in conjunction with other blood sugar-lowering medications like sulfonylureas or insulin.
GLP-1 drugs are not recommended for individuals with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia due to the potential link between these drugs and thyroid tumors in animal studies. They are also not advised for those who have experienced pancreatitis.
The differences between GLP-1 drugs include dosages (with weight loss typically requiring higher doses than diabetes management), the method of administration (most are injectable, but one is available in pill form), additional benefits (some may offer heart protection), age suitability (all are approved for adults, but some are also approved for children), and tolerance (if one GLP-1 drug is not well-tolerated, another may be tried).
Gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation are the most common side effects of GLP-1 drugs. Managing these side effects involves dietary adjustments and hydration. Less common but more serious side effects include pancreatitis, gastroparesis, and bowel obstruction. If experiencing severe side effects or symptoms related to GLP-1 drug use, it’s important to seek medical attention immediately. Additionally, inform your doctor if you are taking GLP-1 drugs and are scheduled for surgery or a procedure requiring general anesthesia, as these drugs slow digestion and may necessitate discontinuation prior to the procedure.