| Who? |
| GLP-1 agonists, also known as incretin mimetics, are recommended for persons with type 2 diabetes who have poorly controlled blood glucose and high Hb A1c levels. On average, most patients find that their HbA1c levels drop by as much as 0.5-1.5% on these medications. |
| What? |
| Injections are given under the skin. An oral option is also available. |
| A few types of GLP-1 agonists are available. Examples are: |
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| Where? |
| These medicines mimic a hormone produced by the body called GLP-1, which helps the pancreas produce insulin. Similarly, GLP-1 agonists stimulate the pancreas to produce more insulin after meals. These drugs also keep food in the stomach longer so that patients feel full sooner, they reduce the liver’s ability to make glucose, and they suppress the appetite. All of these effects promote healthy blood glucose levels in people with type 2 diabetes. |
| When? |
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The treatment plan will differ for each patient, but in general:
- Albiglutide: Patients start with 30 mg injections weekly; if necessary, the health care provider may increase the dose to 50 mg weekly.
- Dulaglutide: Patients start with 0.75 mg injections weekly; after a month, the provider may increase the dose to 1.5 mg weekly. May further increase to 3 mg once weekly, and then to a maximum of 4.5 mg once weekly in 4-week increments if needed.
- Exenatide: Patients start with 5 mcg injections twice daily; after a month, the health care provider may increase the dose to 10 mcg twice daily.
- Exenatide extended release: Patients typically take 2 mg once weekly.
- Liraglutide: Patients start with 0.6 mg once daily injections; after a week, the health provider may increase the dose to 1.2 mg once daily. The maximum dose is 1.8 mg once daily.
- Lixisenatide: Patients start with 10 mcg daily; after two weeks, may be increased to 20 mcg daily by the provider
- Semaglutide (injectable): Patients start with 0.25 mg injections weekly; may increase to 0.5 mg weekly after one month, then 1 mg weekly after another month.
- Semaglutide (oral): Patients start with 3 mg by mouth once daily for one month, then increase to 7 mg once daily. May increase to 14 mg once daily after being on 7 mg dose for one month if needed.
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| Why? |
- Overweight or obese patients generally lose weight on these medications, on average 6.5 pounds (3 kg)
- These drugs are effective at controlling blood glucose with a low risk of hypoglycemia
- Some patients have the gastrointestinal side effects of these drugs such as nausea, diarrhea, and abdominal cramps.
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