Beyond the Pharm Blog
GLP-1 Agonists: Managing Diabetes & Weight Loss
Discover how GLP-1 agonists help lower blood sugar levels and promote weight loss for those with Type 2 diabetes or obesity. Learn about different medication options and find out if they might be right for your health journey.
Understanding GLP-1 Agonists
What Are GLP-1 Agonists?
GLP-1 agonists are injectable medications that mimic the natural hormone GLP-1 (glucagon-like peptide-1) produced in your small intestine. They're primarily used to manage blood sugar levels in people with Type 2 diabetes, but some are also approved for treating obesity.
These medications help your pancreas release insulin, block glucagon secretion, slow stomach emptying, and increase feelings of fullness after eating. This combination of effects helps control blood sugar and can lead to significant weight loss.
GLP-1 agonists work by binding to receptors in your body, mimicking the natural hormone's effects to help manage blood sugar and reduce appetite. Most are administered as subcutaneous injections in areas like your belly, thighs, or upper arms.
Available GLP-1 Medications
Weekly Injections
  • Dulaglutide (Trulicity®)
  • Exenatide extended-release (Bydureon®)
Daily Injections
  • Liraglutide (Victoza®)
  • Lixisenatide (Adlyxin®)
  • Exenatide (Byetta®) - twice daily
Oral Option
  • Semaglutide tablets (Rybelsus®)
  • Taken once daily
  • First oral GLP-1 agonist
*Tirzepatide is technically a dual GLP-1/GIP receptor agonist but works similarly to GLP-1 agonists. Your healthcare provider will determine which medication and dosing schedule is best for your specific needs.
How GLP-1 Agonists Work
Insulin Production
Triggers your pancreas to release insulin when blood sugar is high
Glucagon Blocking
Prevents glucagon release, which stops liver from producing more glucose
Slowed Digestion
Delays stomach emptying to prevent rapid blood sugar spikes after meals
Appetite Control
Affects brain receptors that regulate hunger and fullness sensations
GLP-1 agonists work through multiple mechanisms to help control blood sugar levels and reduce appetite. This comprehensive approach makes them effective for both diabetes management and weight loss.
Benefits Beyond Blood Sugar Control
Cardiovascular Benefits
Studies show GLP-1 agonists may reduce the risk of heart disease and stroke in people with Type 2 diabetes. They can help lower blood pressure and improve lipid profiles, reducing overall cardiovascular risk.
Kidney Protection
These medications may help slow the progression of diabetic nephropathy and reduce the risk of kidney disease. This protective effect is particularly important for people with diabetes who are at higher risk for kidney problems.
Liver Health
GLP-1 agonists have shown promise in improving non-alcoholic fatty liver disease, a common condition in people with Type 2 diabetes and obesity that can lead to serious liver damage if left untreated.
GLP-1 Agonists for Weight Loss

Significant Results
Can help achieve 10-15% weight loss with high-dose formulations
Appetite Reduction
Decreases hunger and increases feelings of fullness
Health Improvements
Better blood pressure, cholesterol, and blood sugar levels
The FDA has approved high-dose semaglutide (Wegovy®) and liraglutide (Saxenda®) specifically for weight management in people with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition. These medications are used alongside diet and exercise for optimal results.
Managing Side Effects
Nausea and Digestive Issues
Most common side effects include nausea, vomiting, and diarrhea. These typically improve over time as your body adjusts to the medication. Eating smaller meals and starting with a lower dose can help minimize these effects.
Appetite Changes
Loss of appetite is expected and part of how the medication works for weight loss. However, it's important to still consume adequate nutrition. Work with your healthcare provider to ensure you're meeting nutritional needs.
Injection Site Reactions
Some people experience redness, itching, or irritation at injection sites. Rotating injection sites and proper injection technique can help minimize these reactions.
When to Call Your Doctor
Contact your healthcare provider if you experience severe or persistent side effects, signs of allergic reaction, or symptoms of pancreatitis (severe abdominal pain, vomiting).
Important Safety Considerations
Pregnancy Concerns
GLP-1 agonists are not recommended during pregnancy. If you're able to become pregnant, use effective birth control while taking these medications. Animal studies have shown potential risks to fetal development.
Pancreatitis Risk
Though rare, these medications have been associated with pancreatitis. Stop taking the medication and seek medical attention if you experience severe abdominal pain that may radiate to your back, with or without vomiting.
Thyroid Concerns
Some GLP-1 agonists carry a boxed warning about thyroid C-cell tumors seen in animal studies. People with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 should not use these medications.
Hypoglycemia Risk
When used with insulin or sulfonylureas, GLP-1 agonists may increase the risk of low blood sugar. Your provider may need to adjust your other diabetes medications when starting a GLP-1 agonist.
Who Should Consider GLP-1 Agonists?
GLP-1 agonists are most beneficial for people with Type 2 diabetes who haven't reached target blood sugar levels with metformin alone, those with obesity or overweight with related health conditions, and those with Type 2 diabetes who also have cardiovascular or kidney disease. They're not FDA-approved for Type 1 diabetes but are sometimes used off-label.
Practical Tips for Using GLP-1 Agonists
Storage
Store unopened pens in the refrigerator. Once in use, most can be kept at room temperature for a limited time (check specific medication instructions).
Timing
Take at the same time each day/week to maintain consistent levels. Some can be taken with or without food.
Monitoring
Check blood sugar regularly and track results. Monitor weight changes and any side effects.
Follow-up
Keep all scheduled appointments with your healthcare provider to assess medication effectiveness.
Combining GLP-1 Agonists with Lifestyle Changes
Nutrition Support
While GLP-1 agonists reduce appetite, maintaining balanced nutrition is crucial. Focus on protein-rich foods, vegetables, and whole grains. Work with a dietitian to create a sustainable eating plan that provides essential nutrients even when appetite is reduced.
Physical Activity
Regular exercise enhances the effects of GLP-1 agonists. Aim for at least 150 minutes of moderate activity weekly. Include both cardio and strength training for optimal health benefits and to preserve muscle mass during weight loss.
Healthcare Team
Work closely with your healthcare providers, including your primary care physician, endocrinologist, and possibly a dietitian or certified diabetes educator. Regular monitoring and adjustments to your treatment plan ensure the best results.
Frequently Asked Questions About GLP-1 Agonists
Will I need to take GLP-1 agonists forever?
Type 2 diabetes and obesity are chronic conditions that typically require long-term management. If you stop taking a GLP-1 agonist, you may regain weight or see blood sugar levels rise again. Your healthcare provider will work with you to determine the optimal duration of treatment based on your specific health needs and goals.
Are GLP-1 agonists covered by insurance?
Coverage varies widely depending on your insurance plan, the specific medication, and whether it's being prescribed for diabetes or weight management. Many plans cover GLP-1 agonists for diabetes treatment but may require prior authorization. Coverage for weight management may be more limited. Check with your insurance provider about coverage details and potential out-of-pocket costs.
Can I take GLP-1 agonists if I don't have diabetes?
Some GLP-1 agonists (specifically high-dose semaglutide and liraglutide) are FDA-approved for chronic weight management in people without diabetes who have obesity (BMI ≥30) or who are overweight (BMI ≥27) with at least one weight-related condition like high blood pressure or high cholesterol. A prescription is required, and these medications should be used alongside diet and exercise.
What happens if I miss a dose?
For daily medications, take the missed dose as soon as you remember, unless it's almost time for your next dose. For weekly medications, take the missed dose as soon as possible if it's within 3-5 days of the scheduled dose (depending on the specific medication). If more time has passed, wait until your next scheduled dose. Always follow the specific instructions for your medication or contact your healthcare provider.