Managing diabetes with GLP-1s

When you have type 2 diabetes, you can feel better and stay healthier when you reach your blood sugar (glucose) goals. Usually you need to follow a meal plan and get some exercise. But you might also need to take medicines. 

Many people with type 2 diabetes take metformin. But other options include newer drugs, like GLP-1 agonists. 

What are GLP-1s? 

GLP-1s (short for glucagon-like peptide-1 receptor agonists) are medicines that help lower blood sugar. They're often used with other diabetes medicines to help manage the disease. You may have heard about these drugs because some of them also are used to help treat obesity. 

Most GLP-1s, including semaglutide (Ozempic), liraglutide (Victoza) and dulaglutide (Trulicity), are injected. 

One GLP-1—semaglutide (Rybelsus)—is a pill taken by mouth. 

A different way to control blood sugar 

GLP-1s work by mimicking hormones in the body that help maintain blood sugar levels. That's different from how other diabetes medicines work. 

For instance: 

• Metformin decreases the amount of glucose produced by the liver and makes it easier for the muscles to use insulin, the hormone that helps glucose enter cells to be used for energy. 

• Sulfonylureas, like glimepiride and glipizide, stimulate the pancreas to release more insulin. 

• Insulin injections replace the insulin that the body has difficulty making or can't properly use. 

Beyond blood sugar control 

GLP-1s are effective at reducing A1C (blood sugar measured over three months) and at helping keep that number in target range. And they can do more than just manage blood sugar numbers. They also may help reduce the risk of heart disease and end-stage kidney disease, two major complications of diabetes. 

Because GLP-1s reduce hunger and increase feelings of fullness, they may also help people lose weight. Some GLP-1s—like Wegovy (a brand name for semaglutide)—are prescribed as weight-loss drugs in people who don't have diabetes. 

What are the side effects? 

Some of the most common side effects of GLP-1s are gastrointestinal issues, including: 

• • Nausea. 
• • Vomiting. 
• • Diarrhea. 

More serious risks include pancreatitis (inflammation of the pancreas) and gastroparesis (when food moves too slowly out of the stomach). 

GLP-1s can be expensive. But a lower-cost, generic version of liraglutide is now available. 

Are GLP-1s right for you? 

Talk to your doctor. Together you can decide if GLP-1s are the best way to manage your diabetes. A primary care provider is a great place to start to monitor your blood sugar levels and chronic conditions like diabetes. If you are looking for a primary care provider, visit www.lcmh.com/find-a-doc.

Sources:

American Diabetes Association

Centers for Disease Control and Prevention

National Library of Medicine