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A Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs) is drug used to control Type 2 diabetes and promote weight loss. GLP-1 RAs were originally developed to help patients with type 2 diabetes control their blood glucose (sugar) levels. However, GLP-1 RAs are now prescribed for weight loss for non-diabetic patients with obesity. Keeping up to date on medical breakthroughs can be like trying to learn a new language. Below is a set of terms most commonly associated with GLP-1 RAs.
- Agonist: an agonist is a substance that binds itself to a specific receptor and produces a physiological effect.
- Anorexigen or Anorectic Drug: a medication that suppresses the appetite
- Behavior Modification: an intervention used to mitigate or eliminate maladaptive behaviors.
- Body Mass Index (BMI): measure of body fat based on height and weight. It is used as a metric to help health care providers determine a patient’s risk for health conditions such as type 2 diabetes or cardiovascular disease.
- Blood Glucose: glucose is the sugar found in one’s blood.
- Blood Glucose Level: the amount of sugar in one’s blood. Normal blood glucose levels vary by age. For adults without diabetes, fasting glucose should be ≤ 100 mg/dL.
- Cardiovascular Disease: a general term used for diseases that affect the function or structure of one’s heart, blood vessels, or arteries. Examples of cardiovascular disease are coronary artery disease, angina, stroke, or arrhythmia.
- Cardiovascular Risk Factors: examples of risk factors include high blood pressure, high cholesterol, obesity, diabetes, sedentary lifestyle, or poor diet.
- Cholesterol: a waxy substance in your body made by the liver. It is needed to build cells and make vitamins and hormones. Cholesterol comes from foods such as meat, poultry, and dairy products. High-density lipoprotein (HDL) is the “good” cholesterol that removes other cholesterol from your bloodstream. Low-density lipoprotein (LDL) is the “bad” cholesterol; high LDL levels can increase your risk for heart disease or stroke.
- Clinical Trial: a clinical trial is a research study that assesses a medical, surgical, or behavioral intervention on human health outcomes. Before going to market, the safety and effectiveness of medications assessed in a clinical trial.
- Diabetes-related Neuropathy: nerve damage in hands, legs, or feet caused by uncontrolled or unmonitored diabetes.
- Gastrointestinal Issues: GLP-1 medications can cause gastrointestinal issues such as nausea, vomiting, stomach pain, diarrhea, indigestion, bloating, and in rare cases pancreatitis.
- Glucagon: hormone produced by the pancreas to help regulate blood glucose levels.
- Glucagon-Like Peptide (GLP-1) Agonist: GLP-1 Receptor Agonists medications mimic the action of the glucagon-like peptide 1 hormone, which is naturally released in your gastrointestinal tract when you eat. GLP-1 RAs signal your pancreas to release insulin and your body to release glucagon, each of which controls blood glucose (sugar) levels in people with type 2 diabetes. GLP-1 RAs also signal the brain receptors to delay stomach emptying so that you will feel full longer.
- Glucagon-Like Peptide (GLP-1) Agonist Compounding: compounding pharmacies produce custom made medications to fit the consumer’s needs. Due to the Ozempic and Wegovy shortage, compounding pharmacies have begun making these medications from scratch. The FDA has found evidence of fraudulent medications identified as weight loss drugs, so be sure to talk with your health care provider before purchasing a GLP-1 RA from a compounding pharmacy.
- Glucagon-Like Peptide (GLP-1) Agonist Supplements: there is speculation that the GLP-1 hormone can be increased via supplements such as berberine, yerba mat, curcumin, and ginseng. While there is some evidence to suggest that GLP-1 levels could be increased naturally with supplement, these supplements are not as effective as the actual medication. Be sure to consult with your health care provider before pursuing GLP-1 supplements as part of your weight loss strategy.
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Glutide Medications:
- Dulaglutide once-weekly: available under the brand name Trulicity. Dulaglutide is used to treat type 2 diabetes.
- Exenatide twice-daily: available under the brand names Byetta and Bydureon BCISE. Exenatide is used to treat type 2 diabetes. Exenatide twice-daily is available in prefilled pens that contain 250 mcg/mL in either a 1.2 mL prefilled pen with a 5 mcg dose and a 2.4 mL prefilled pen with a 10 mcg dose. Exenatide should be injected twice daily within one hour of morning and evening meals. This medication is manufactured by Eli Lilly.
- Exenatide extended release once weekly: available under the brand names Byetta and Bydureon BCISE. Exenatide extended release is available in a prefilled injection pen or single use vials that contain a 2 mg dose. This medication is manufactured by Eli Lilly.
- Liraglutide once-daily injection: available under the brand names Saxenda, Victoza, and Zultophy. Liraglutide is used to treat type 2 diabetes. For adults, dosing starts at 0.6mg and then increased to 1.2 mg daily after one week. This medication is manufactured by Novo Nordisk.
- Lixisenatide once-daily injection: available under the brand name Adlyxin. Lixisenatide dosing begins with 10 mcg once per day for 14 days. The dosage increase to 20 mcg on day 15. Lixisenatide should be administered within one hour before the first meal of the day.
- Relatrutide triple hormone receptor: Relatrutide is currently being assessed in a Phase 2 trial as a treatment for obesity. This medication is manufactured by Eli Lilly and Company.
- Semaglutide once-weekly: available under the brand names Ozempic, Rybelsus, and Wegovy.
- Tirzepatide: available under the brand names Mounjaro and Zepbound.
- Hormones: chemical messengers in the body that help to control how cells and organs work. Insulin is an example of a hormone.
- Hyperglycemia: high blood glucose levels. It is a signal that your body may not be producing enough insulin or is not responding appropriately to insulin. Hyperglycemia can be dangerous because it can lead to kidney damage, vision problems, nerve damage, or cardiovascular disease.
- Hypoglycemia: low blood glucose levels. Low blood sugar signals epinephrine (adrenaline) to be released. This leads to increased heart rate, sweating, nervousness or anxiety, or feeling shaky. Hypoglycemia can be dangerous because it can lead to blurred vision, confusion, numbness, difficulty concentrating, or slurred speech.
- Hypertension: high blood pressure, typically characterized by a reading of higher than 180/120. High blood pressure can lead to a heart attack, heart disease, or stroke.
- Insulin: hormone produced in the pancreas. It regulates how much glucose (sugar) is in the bloodstream.
- Insulin Resistance: cells, muscles, fat, and your liver are not responding to insulin in your body. Your body cannot take up glucose from your blood or store it. Insulin resistance is sometimes referred to as insulin insensitivity.
- Lipids: waxy, fatty, oily compounds in your body that help move and store energy; they absorb vitamins and make hormones.
- Long-acting Drug: medications with active ingredients that are releases slowly.
- Low Calorie Diet (LCD): restricting daily caloric intake to 800 – 1500 calories.
- Neurotransmitter: messenger service in your body that carry chemical signals from one nerve cell to a destination nerve cell, e.g., another nerve cell, a muscle cell, or a gland cell. Neurotransmitters regulate hormones, digestion, hunger, thirst among many other important body functions.
- Non-alcoholic Fatty Liver Disease: buildup of excess fat in the liver. Risk factors include diabetes, obesity, and a high-fat diet. If not treated, it can lead to death.
- Medullary Thyroid Cancer: rare form of thyroid cancer, responsible for roughly 3 percent of all thyroid cancer cases.
- Multiple Endocrine Neoplasia: rare disorder of the endocrine system. It is caused by a genetic mutation that affects multiple glands in the endocrine system.
- Nutritionally Designed Meal Replacement: dietary alternative that can be substituted for one or two meals per day. A nutritionally designed meal replacement is a shake, pudding, or bar that meets daily allowances for protein, fiber, carbohydrates, vitamins, and minerals.
- Obesity: chronic health condition characterized by excess fat. Its causes are complex, ranging from genetics, environmental, behavioral, metabolic, or hormonal factors. Risk factors include an unhealthy diet, inactivity, family history, age, race, socioeconomic status, stress, and poor sleep quality.
- Pancreas: an organ located behind the stomach in the upper left quadrant of the abdomen. The pancreas produces enzymes that are critical for digestion and it produces insulin, which is implicated in blood glucose. The pancreas also produces glucagon, which is implicated in raising blood sugar.
- Pancreatitis: inflammation of the pancreas. It can be chronic or acute and is characterized by abdominal pain, nausea, vomiting, or fever. If not treated
- Pharmacology / Pharmacological: study of how natural and synthetic (e.g., drugs) chemicals affect biology.
- Receptor: molecule in or on a cell’s surface that binds to another substance to produce a specific effect in the cell.
- Short-acting Drug: medications that work more quickly, typically within 30 – 45 minutes.
- Side Effects: common side effects from GLP-1 medications include nausea, vomiting, diarrhea, bloating, and fatigue,
- Small intestines: responsible for breaking down food, absorbing nutrients, and eliminating unnecessary substances. The small intestines transfer food to the large intestines / colon.
- Stomach (Gastric) Emptying: measure of the time it takes for stomach (gastric) contents to be transferred to the duodenum.
- Subcutaneous: beneath or below the skin’s surface.
- Tachycardia: increased heart rate for any reason.
- Triple Hormone Receptor Agonist: Retatrutide is an example of an agonist of the glucose-dependent polypeptide, glucagon-like peptide 1, and glucagon receptors.
- Type 2 Diabetes: medical condition related to how the body uses sugar. This could be caused by a problem with how the pancreas is producing insulin and cells responding poorly to insulin.
- Very Low Calorie Diet (VLCD): restricting daily caloric intake to 800 calories or less.