GLP 1 agonist first came in the type 2 diabetes treatment arsenal more than 15 years ago for blood sugar control. Four of GLP-1 agonists are exclusively available as a subcutaneous injection. The immediate-acting exenatide (Byetta 5 and 10 g) requires two daily injections, whereas the prolonged-release type requires one weekly injection (Bydureon). Liraglutide (Victoza) requires only one daily injection; it is also available in a fixed combination with degludec, an insulin analogue (Xultophy). Dulaglutide is given once a week as an injection (Trulicity 0.75 and 1.5 mg).Semaglutide (Ozempic 0.25, 0.5, and 1 mg) is a more recent weekly form.

When the glycemic target cannot be met with metformin alone in individuals with high vascular risk and a BMI greater than 30 kg/m2, they should be the primary therapeutic option.

Before metformin, GLP-1 agonist appeared to provide a number of advantages in patients with a high vascular risk. These medications, however, have a very high monthly cost of roughly $80, compared to $4 for 2 g/d metformin (MET).

What are GLP-1 Agonists prescribed for?

Incretin mimetics, also known as glucagon-like peptide-1 receptor agonists, are a class of prescription drugs that have been shown to be beneficial in the treatment of type 2 diabetes and weight loss.

To comprehend GLP-1 receptor agonists, we must first comprehend ‘natural’ GLP-1: GLP-1 is a strong hormone produced by the human body that sends messages to the brain to control metabolic function, make you feel full, and reduce your appetite. GLP-1 signaling appears to be reduced in persons who hang on to more weight, according to research.

GLP-1 agonists are medications that replicate the actions of natural GLP-1, assisting in the regulation of blood sugar levels and weight loss in a variety of ways, one of the most important of which is by increasing the feeling of fullness (or satiety) after meals.

The Food and Drug Administration first approved GLP-1s as a type 2 diabetic treatment in 2005. GLP-1s, on the other hand, not only improved glucose levels, but also resulted in weight loss and other metabolic health benefits, according to specialists. Liraglutide (Saxenda) was the first GLP-1 agonist to be licensed by the FDA for weight loss in obese people without diabetes in 2014.

GLP 1 agonist medicines are generally considered to be safe, effective, and have few side effects. Any common side effects, such as nausea, that patients may experience while taking GLP-1s are usually tolerable.

There are warnings and contraindications to bear in mind before commencing therapy with GLP-1 medicine, whether it’s as part of your diabetic care plan or as part of a medical weight loss program, as there are with any prescription medications. 

Keep in mind that insulin and metformin are not GLP-1 agonists, but they may be used in conjunction with GLP-1s.

GLP-1 agonist

 

Incretin hormones (‘natural’ GLP-1) are mimicked by GLP-1 agonists in the body. These hormones indicate that food has been ingested to the brain, endocrine system, and gastrointestinal system. A complex cascade of hormones and neurotransmitters is produced as a result, effectively communicating sensations of satiety.

These hormones are also important in the control of blood sugar levels, and they can help persons with impaired glucose tolerance or diabetes.

Here’s a closer look at GLP-1’s multiple interactions with your other organ systems:

  • GLP-1 receptors in the hypothalamus—the area of the brain that controls hunger and thirst—tell you to stop eating and make food less enticing in the brain.
  • GLP-1 agonists enhances fatty acid and glucose absorption in the muscles, allowing them to be broken down as a fuel source (through beta oxidation or glycolysis).
  • GLP-1 agonists slows the pace at which food is digested and removed from the stomach in the stomach, which helps to prolong the feeling of fullness after a meal and promotes fullness even with lower servings.
  • GLP-1 agonist hepatic glucose output (gluconeogenesis) in the liver, which helps persons with impaired blood sugar metabolism lower their blood sugars.
  • GLP-1 agonist stimulates insulin synthesis while suppressing glucagon release in the pancreas, resulting in better blood sugar control and sugar consumption for energy and storage in the body; this is especially significant in persons with impaired glucose tolerance, pre-diabetes, or diabetes.

GLP-1 Agonists prescribed by Calibrate

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GLP 1 Agonist GLP-1 agonists

GLP-1 Agonist

 

Calibrate prescribes a small number of GLP-1 agonist that are either intended for weight loss directly or for weight loss off-label. The following drugs are among them:

  • Liraglutide (Saxenda®)
  • Dulaglutide (Trulicity®)
  • Semaglutide (Ozempic®, Wegovy®, Rybelsus®)

GLP-1 Agonists are listed alphabetically by brand name

Adlyxin® (lixisenatide)

Drug class: GLP-1 Agonists

What is Adlyxin®? Adlyxin® is a once-daily subcutaneous injectable prescription drug that, when combined with diet and exercise, may improve blood sugar (glucose) management in persons with type 2 diabetes. Adlyxin® should not be used by those who have type 1 diabetes. It comes in the form of a disposable pre-filled pen.

Dose: Adlyxin® has a beginning dosage of 10 mcg daily and titrates up to a maintenance dose of 20 mcg.

Manufacturer: Sanofi

Drug class: GLP-1 Agonists

What is Bydureon BCise®? Bydureon BCise® is a once-weekly subcutaneous injectable exenatide extended-release suspension. It is used to enhance blood sugar management in adults and children aged 10 and up who have type 2 diabetes mellitus, and it should be taken in conjunction with diet and exercise. It is not indicated as a first-line treatment for diabetes and is not suitable for persons with type 1 diabetes.

Dose: 2 mg subcutaneous injection per week.This medication comes in a prefilled pen

Manufacturer: AstraZeneca

Drug class: GLP-1 Agonists

What is Byetta®? Byetta® is a twice-daily subcutaneous injectable drug used to help persons with type 2 diabetes regulate their blood sugar levels in addition to diet and exercise. It can be used with other diabetic medications taken orally.

Dose:Byetta® comes in a 5 mcg twice-daily beginning dosage and titrates up to 10 mcg twice-daily dose.

Manufacturer: AstraZeneca

Drug class: GLP-1 Agonists

What is Ozempic®? One of the GLP-1 drugs recommended by Calibrate physicians is Ozempic®, a once-weekly subcutaneous injectable treatment. Since 2017, it has been FDA-approved. While Ozempic® is now FDA-approved for use in type-2 diabetic patients, there is evidence that its active component is safe and beneficial in the treatment of overweight or obesity. Ozempic® can improve blood sugar levels in individuals with insulin resistance or prediabetes, just as it can in those with type-2 diabetes, and is an useful tool for weight loss in both groups.

Dose: Ozempic® is taken once a week at a beginning dose of 0.25 mg and titrated up to 1.0 mg once a week. This drug is available in the form of a pre-filled pen.

Manufacturer: Novo Nordisk

Drug class: GLP-1 Agonists

What  is Rybelsus®? Rybelsus® is a once-daily prescription drug that is one of the GLP-1 medicines that Calibrate physicians give. Rybelsus, unlike many other GLP-1 drugs, is taken orally (as a pill) first thing in the morning on an empty stomach. While Rybelsus® is now FDA-approved for use in type-2 diabetic patients, there is evidence that its active component is safe and beneficial in the treatment of overweight or obesity. Rybelsus® can improve blood sugar levels in individuals with insulin resistance or prediabetes, just as it can in those with type-2 diabetes, and is an useful tool for weight loss in both groups.

Dose: Rybelsus® has a starting dosage of 3 mg once day and titrates up to 14 mg once daily.

Manufacturer: Novo Nordisk

Drug class: GLP-1 Agonists

What is Saxenda®? Saxenda® is a weight-loss medicine that is FDA-approved and safe. It is a once-daily subcutaneous injectable prescription medicine used to help adults with excess weight who also have weight-related medical problems or obesity lose weight and keep it off, as well as children aged 12-17 years with a body weight greater than 132 pounds (60 kg) and obesity lose weight and keep it off. Saxenda® should be taken in combination with a comprehensive lifestyle program that includes good eating habits and regular exercise. One of the GLP-1 drugs given by Calibrate physicians is Saxenda®.

Dose: Saxenda® has a starting dosage of 0.6 mg and titrates up to 3.0 mg. This drug is available in the form of a prefilled pen.

Manufacturer: Novo Nordisk

Drug class: GLP-1 Agonists

What is Trulicity® ? One of the GLP-1 drugs recommended by Calibrate physicians is Trulicity®, a once-weekly subcutaneous injectable treatment. While Trulicity® is now FDA-approved for use in type-2 diabetic patients, there is evidence that its active component is safe and beneficial in the treatment of overweight or obesity. Trulicity® can improve blood sugar levels in individuals with insulin resistance or prediabetes, just as it can in adults with type-2 diabetes, and is an effective strategy for weight loss in both groups.

Dose: Patients are given 0.75 mg subcutaneous injections once a week, with dosages titrated up to 4.5 mg once a week. This drug is available in the form of a prefilled autoinjector.

Manufacturer: Eli Lilly and Company

Drug class: GLP-1 Agonists

What is Victoza®? Victoza® is a once-daily subcutaneous injectable drug that is used in combination with diet and exercise to help people with type 2 diabetes manage their blood sugar levels. In individuals with type 2 diabetes and known heart disease, Victoza® may help lower A1C and reduce the risk of serious cardiovascular events such as heart attack, stroke, or death. While Victoza® is now FDA-approved for the treatment of type 2 diabetes, its active component is also safe and effective in the treatment of obesity. Victoza® can improve blood sugar levels in individuals with insulin resistance or prediabetes, just as it can in those with type 2 diabetes, and is an effective weight-loss aid in both groups.

Dose: Victoza can be taken in dosages of 0.6 mg, 1.2 mg, or 1.8 mg with the Victoza pen. The beginning dose is 0.6 mg, and the amount is gradually increased to a maximum of 1.8 mg per day. This drug is available in the form of a pre-filled pen.

Manufacturer: Novo Nordisk

Drug class: GLP-1 Agonists

Manufacturer: Novo Nordisk

What exactly is Wegovy®? In June 2021, the FDA authorized Wegovy®, a once-weekly subcutaneous injectable GLP-1 for weight reduction. It’s one of the Calibrate physicians’ recommended drugs for use in combination with the Calibrate One Year Metabolic Reset. It’s one of just six drugs authorized by the FDA to treat obesity right now.

Dose: Wegovy® starts with a 0.25 mg subcutaneous once weekly starting dosage and titrates up to a maintenance dose of 2.4 mg once weekly. This drug is available in the form of a prefilled pen.

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