When a person has type 2 diabetes, there’s a process in their body that’s gone awry: It may not make insulin or may not use it well. The result is high blood sugar, which can cause a cascade of health problems, including heart and kidney damage.
To help, their doctor will come up with a treatment plan, which includes exercise and a specific way of eating—and these days, it may also include a type of medication to reduce blood sugar called GLP-1. GLP-1 for diabetes also helps with weight loss, and that can further bring high blood sugar levels down.
“What’s really a game changer is the fact that there’s one medicine that provides multiple benefits at the same time,” says Evan Sisson, PharmD, a professor at the VCU School of Pharmacy in Richmond, Virginia. “It not only affects the blood glucose that we’re concerned about today, but also the downstream complications of diabetes, like heart disease and kidney disease.”
GLP-1 is generally well tolerated and conveniently packaged as a weekly shot, he adds.
How GLP-1 works
GLP-1 belongs to a class of prescription medications that lower blood sugar called glucagon-like peptide-1 (GLP-1) receptor agonists. When you eat, your gastrointestinal (GI) tract releases the hormone GLP-1. An important function of that hormone is to signal the pancreas to release insulin to lower your blood sugar.
GLP-1 mimics the actions of GLP-1: When you eat, the medication signals the pancreas to release insulin, which lowers your blood sugar. It also tells your brain when you’re full, reducing your appetite and cravings. “The GLP-1 agonists ping the receptors in the brain that promote satiety, that tell people ‘you can stop eating now,’” Sisson says.
GLP-1 also slows food moving through your digestive system. “People feel fuller, so they tend to eat less,” he explains. “The net result is that the blood sugars come down, and people lose weight.”
GLP-1 and type 2 diabetes
The best way to see if GLP-1 is right for you? Have a conversation with your doctor. Each diabetes treatment plan is specific to the person and takes into account factors such as medical history, medical conditions, and prescription meds. Your doctor will also consider whether diet, exercise, and current medications have been successful in controlling your blood sugar.
Sometimes GLP-1 is combined with other medications to control blood sugar, according to Mayo Clinic. For example, you may already take metformin, a low-cost oral medication that can be very effective in lowering blood sugar (it’s the most commonly prescribed med for type 2 diabetes). But if your blood sugar is still not under control, your doctor may consider adding GLP-1 to your treatment plan.
In the American Diabetes Association’s (ADA) Standards of Care for Diabetes–2024, GLP-1 is one of the recommended treatment options for people with type 2 diabetes and overweight or obesity, as well as those at high risk for heart or kidney disease.
Combining a healthy diet with a prescription GLP-1 creates a powerful approach to effective weight loss.
How GLP-1 can help people with type 2 diabetes
The benefits of GLP-1 for people with diabetes include the following:
- It effectively lowers blood sugar. High blood sugar can cause health problems such as heart disease, stroke, kidney problems, nerve damage, and eye problems in people with type 2 diabetes. So when blood sugar is controlled, it helps prevent these complications. (Don’t miss our Goldilocks guide to getting your blood sugar just right.)
- It supports weight loss. A decreased appetite leads to weight loss. However, research has shown a difference in how much weight is lost by overweight or obese people on GLP-1, depending on whether they have type 2 diabetes or not: Those who don’t have diabetes tend to lose more weight. Additional research is needed to understand why.
- It protects heart health. “Compared to the rest of the population, having type 2 diabetes increases your risk of a cardiac event, two to four fold,” says Sisson. GLP-1 reduces the risk of stroke, heart attack, and death in people who have type 2 diabetes and heart and blood vessel disease, research shows.
- It protects kidney health. About one in three people with diabetes develop chronic kidney disease. One study found that GLP-1 significantly reduces the risk of kidney failure, substantial loss of kidney function, and death in those with type 2 diabetes and chronic kidney disease.
- It’s convenient. People can inject GLP-1 weekly at home. Many other diabetes medications are daily oral medications, which can be easier to forget and may have more complicated dosing instructions.
Side effects to consider
The most common side effects when on GLP-1 are GI-related, such as nausea, constipation, vomiting, and abdominal pain. There’s also an increased risk of pancreatitis (inflammation of the pancreas).
The GI side effects are a result of food moving more slowly through your GI tract. “Food stays in your stomach longer,” Sisson says. “It’s like having a big Thanksgiving meal that sits there.” Eating smaller meals can help alleviate those side effects, and your doctor might also recommend anti-nausea medicine.
Side effects tend to decrease over time, so to help your body adjust to GLP-1, your doctor may start you on a lower dose and ramp up.
Finding the right path for you
If you have type 2 diabetes and are interested in exploring whether GLP-1 is a good choice, the best place to start is to have a discussion with a doctor. You and your doctor can talk about the various medication options that are available for those in your situation and discuss next steps. There are some common reasons to not to take GLP-1, including if you have:
- Pancreatitis
- Gastroparesis
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple endocrine neoplasia syndrome type 2 (MEN 2, an endocrine condition)
If you think a weight loss medication like GLP-1 might be right for you, chat with a ReflexMD Wellness Advisor now or take our short quiz to see if you qualify.
Read Next: 4 Scary Diabetes Complications—And How To Avoid Them
