GLP-1 receptor agonists are incretin-based therapies that enhance glucose-dependent insulin secretion and promote weight loss.

They are foundational agents in:

• Type 2 Diabetes • Obesity • Atherosclerotic Cardiovascular Disease (ASCVD)

Unlike SGLT2 Inhibitors, GLP-1 agents primarily reduce atherosclerotic events rather than heart failure hospitalization.

GLP-1 (Glucagon-Like Peptide-1) is an incretin hormone released from the gut after meals.

GLP-1 receptor agonists:

• Increase glucose-dependent insulin secretion • Decrease glucagon secretion • Slow gastric emptying • Increase satiety • Promote weight loss

Net Effects:

• ↓ Blood glucose • ↓ Postprandial glucose • ↓ Body weight • ↓ Major adverse cardiovascular events (MACE)

They do NOT cause insulin release in the absence of glucose → low hypoglycemia risk.

• Semaglutide • Liraglutide • Dulaglutide • Exenatide

(Additional agents may be added as PharmAtlas expands.)

• Glycemic control • Weight reduction • Reduction of ASCVD risk

• Significant weight loss • Reduces visceral adiposity • Improves metabolic profile

GLP-1 receptor agonists reduce:

• Myocardial infarction • Stroke • Cardiovascular death

Particularly beneficial in patients with established ASCVD.

→ Cardiovascular Modules

• They are NOT core therapies for heart failure. • They do NOT provide strong HF hospitalization reduction.

For heart failure benefit, see:

→ SGLT2 Inhibitors

Common:

• Nausea • Vomiting • Diarrhea • Early satiety

Serious (rare):

• Pancreatitis • Gallbladder disease • Medullary thyroid carcinoma risk (theoretical; avoid in MEN2)

• Personal or family history of medullary thyroid carcinoma • MEN2 syndrome • Severe GI disease

Use caution in:

• Pancreatitis history

GLP-1 receptor agonists:

• Strong weight loss • Strong ASCVD benefit • Minimal HF benefit

SGLT2 Inhibitors:

• Strong HF benefit • Strong CKD protection • Mild weight loss

These classes are often complementary.

✔ Glucose-dependent insulin release ✔ Promote weight loss ✔ Reduce atherosclerotic events ✔ Low hypoglycemia risk (unless combined with insulin) ✔ Not primary HF therapy ✔ Complementary to SGLT2 inhibitors

Related:

→ SGLT2 Inhibitors → Heart Failure Module → Cardiovascular Modules → Endocrine Pharmacology