Medicine & USMLE

GLP-1 Analogs

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Diabetes Drugs (New)
  1. DPP-4 Inhibitors
  2. GLP-1 Analogs
  3. Pramlintide (Amylin Analogs)
  4. SGLT2 Inhibitors
  5. Metformin (Biguanides)

Summary

GLP-1 Analogs are a class of drugs that include exenatide and liraglutide. These drugs are used to treat type 2 diabetes mellitus by lowering blood sugar levels. As their name suggests, these drugs work by imitating the actions of GLP1 in the body, which stimulates glucose-dependent insulin release and decreases glucagon release. These drugs also decrease gastric emptying and increase satiety. A common side effect of these drugs is nausea and vomiting, while a much rarer side effect is pancreatitis. The GLP1 analogs are also known to cause weight loss in patients. Finally, these drugs typically do not cause hypoglycemia in patients.

Key Points

  • GLP-1 Analogs
    • Drug Names
      • Exenatide
      • Liraglutide
      • Note: this is not a unique drug ending, but both end in -tide
    • Mechanism
      • Mimics action of endogenous glucagon-like peptide 1 (GLP-1) to activate GLP-1 receptors
        • Decreases glucagon release
        • Decrease gastric emptying
          • Increases satiety
            • often desired
        • Increase glucose-dependent insulin release
          • This occurs in a glucose-dependent fashion, so hypoglycemia is not observed
          • Think: uses indirect machinery (does not directly act on beta cells, so body’s homeostatic effects remain intact)
    • Clinical Use
      • Treats diabetes mellitus
        • Used second-line in patients who do not achieve sufficient glucose control with metformin or other drugs
    • Side Effects
      • Nausea / vomiting
      • Pancreatitis
      • Weight loss
        • often desired
      • Does not cause hypoglycemia
        • Since insulin is released in a glucose-dependent manner, insulin release stops when glucose levels fall too low