Pros and Cons of GLP-1 use
Pros and Cons of GLP-1s
Glucagon-like peptide-1 receptor agonists (GLP-1s) are a class of medications primarily used to manage type 2 diabetes and, more recently, obesity. They mimic the action of the natural GLP-1 hormone, which helps regulate blood sugar levels and appetite.
Here’s an overview of pros and cons.
Pros:
1. Effective Blood Sugar Control: GLP-1s lower blood sugar by increasing insulin secretion, reducing glucagon levels, and slowing gastric emptying.
2. Weight Loss: Unlike some diabetes medications that can cause weight gain, GLP-1s promote weight loss by suppressing appetite and reducing caloric intake
3. Cardiovascular Benefits: GLP-1s have shown cardiovascular protective effects, reducing risk of heart attack and stroke in people with type 2 diabetes
4. Low Risk of Hypoglycemia: GLP-1s do not typically cause hypoglycemia.
5. Improved Adherence: Long-acting formulations allow weekly dosing which improves convenience and adherence
6. Potential Kidney Benefits: Some evidence suggests GLP-1s may have protective effects on kidney function in diabetes patients.
Cons:
1. Gastrointestinal Side Effects: Common issues include nausea, vomiting in a few, diarrhea or constipation, particularly when starting treatment or increasing the dose.
2. Cost: GLP-1s are expensive and may not be covered by all insurance plans and will not cover if individual does not have major health problems and a bmi>30.
3. Injection Requirement: Most GLP-1s are injectable which may deter some individuals.
4. Risk of Pancreatitis: Although rare, GLP1-s may increase the risk of pancreatitis. Monitoring is essential in patients with a history of pancreatitis.
5. Potential Thyroid Concerns: GLP-1s carry a warning for potential risk of medullary thyroid carcinoma (MTC) in animal studies, though this has NOT been confirmed in humans.
6. Not Suitable for All Patients: Contraindicated in people with a personal or family history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2).
7. Side Effects with Higher Doses: When used for weight loss, higher doses can amplify side effects, including gastrointestinal discomfort.
Conclusion:
GLP-1s are highly effective for managing blood sugar and promoting weight loss, with added cardiovascular and other health benefits including decreasing rate/risk of 14 obesity related cancers (colon, endometrial, etc) as per MD Anderson. However, their cost, side effects, and injectable nature may limit their appeal or suitability for some individuals. A healthcare provider at ModMed can help weigh these factors based on a persons specific health needs and goals.
