Glucagon-like peptide 1 (GLP-1) receptor agonists (drugs that bind a receptor and cause an effect) are anti-hyperglycemic drugs that are now widely used for weight loss in obese people and to treat type 2 diabetes. While various benefits of these agents have been reported, including management of obesity and cardiovascular risk reduction, several risks are associated with their use. Are these drugs right for you?
Understanding the side effects of GLP-1 agonists helps to understand how they work. GLP-1 is a hormone made by the small intestine. When this hormone is released, it triggers insulin release from the pancreas. Insulin is an essential hormone that causes cells to take up glucose from the blood, lowering blood glucose (sugar) levels and providing energy substrate for our tissues. Insufficient insulin secretion from the pancreas results in type 1 diabetes.
GLP-1 slows emptying from the stomach and intestine. This and its effects on the brain make us feel less hungry.
The most common side effects of GLP-1 drugs are related to the GI tract and are mild-to-moderate in severity. Slowing gut motility may be associated with nausea, vomiting, constipation,and indigestion. Other common side effects include diarrhea, dizziness, sleep disturbance, joint pain, and headaches. Usually, these symptoms occur early on and diminish over time, but sometimes they can be quite bothersome and cause people to stop taking the drug.
GLP-1 agonists have rarely caused severe adverse reactions. A small number of people may be allergic to these drugs. There is a risk of pancreatitis, or inflammation of the pancreas, that may be life-threatening. GLP-1 agonists have been associated with gallstones (https://pubmed.ncbi.nlm.nih.gov/26177483/). These agents may cause an increase in heart rate and a reduction in blood pressure and blood glucose – these changes may casue syncope (fainting). ()
Another issue related to GLP-1 agonists is their cost. Especially in combination with GI side effects, this may cause some people to stop taking the drug.
We will continue to learn more about benefits of GLP-1 drugs beyond weight loss, blood sugar control, and cardiovascular risk reduction as more and more people use these novel agents over time. Similarly, additional information regarding risk factors will likely emerge.
Let’s educate ourselves and discuss the pros and cons of these remarkable drugs before embarking on treatment!
Note: Although I am a physician, the content in this article is not meant to diagnose, treat, cure or prevent illness or disease in the reader – it is for educational purposes only.
References
- Ghusn W, Hurtado MD. Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks. Obesity Pillars 2024;12:100127. https://www.researchgate.net/publication/383612802_Glucagon-like_Receptor-1_Agonists_for_Obesity_Weight_Loss_Outcomes_Tolerability_Side_Effects_and_Risks
- Filippatos TD, Panagiotopoulou, Elsaf M. Adverse effects of GLP-1 agonists. Rev Diabet Stud 2014;11(3-4):202-30. https://pubmed.ncbi.nlm.nih.gov/26177483/
- Bettge K, Kahle M, Abd El Aziz MS, et al. Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: A systematic analysis of published clinical trials. Diabetes Obes Metab. 2017 Mar;19(3):336-347. doi: 10.1111/dom.12824. https://pubmed.ncbi.nlm.nih.gov/27860132/
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