GLP1analogen

GLP-1 analogs, or GLP-1 receptor agonists, are a class of incretin-based medications that imitate the action of the endogenous hormone glucagon-like peptide-1 (GLP-1). They enhance glucose-dependent insulin secretion, suppress inappropriate glucagon release, slow gastric emptying, and reduce appetite, thereby improving glycemic control and often promoting weight loss. They are used primarily for type 2 diabetes and, at higher doses, for obesity.

Most GLP-1 analogs are peptide drugs modified to resist rapid breakdown by DPP-4 and to have a longer half-life. As a result, many are given by subcutaneous injection once weekly or once daily, while oral semaglutide provides an oral option. Common examples include exenatide, liraglutide, dulaglutide, lixisenatide, and semaglutide.

In type 2 diabetes, GLP-1 analogs are typically added when metformin alone does not achieve target glycemic control and they have been shown to reduce major adverse cardiovascular events in patients with high cardiovascular risk in several outcome trials. In obesity, higher-dose regimens are approved for sustained weight loss. They generally have a lower risk of hypoglycemia when used alone, but the risk increases if combined with insulin or sulfonylureas.

Adverse effects are mainly gastrointestinal, such as nausea, vomiting, and diarrhea, and often diminish over time. Serious but rare risks include pancreatitis and cholelithiasis; animal studies have shown a risk of thyroid C-cell tumors, though the relevance to humans is uncertain. Contraindications include a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2. They should be used in pregnancy only when clearly needed.