Understanding GLP-1 RA treatment

GLP-1 receptor agonists (RAs) are anti-diabetic medications that mimic the effects of a natural hormone involved in blood sugar regulation and appetite control for individuals with diabetes mellitus. GLP1-RAs offer multiple benefits for people managing diabetes - particularly those with type 2 diabetes¹. They are often introduced when lifestyle changes and 1^st line anti-diabetic medications like metformin alone aren't enough.

GLP-1 receptor agonists (RA) work by activating the same receptors as the body’s natural GLP-1 hormone to help lower blood sugar. This leads to a combination of effects that improve glucose balance and appetite regulation, which is particularly beneficial for patients with kidney disease.

GLP-1 medications help manage blood sugar in several key ways, including:

• Increasing insulin secretion - but only when glucose levels are high
• Reducing glucagon levels to prevent excess glucose release from the liver
• Slowing gastric emptying to reduce blood sugar spikes after meals
• Suppressing appetite, which can support weight management

This multi-action approach makes GLP-1 therapy a valuable option in diabetes management - particularly for people with type 2 diabetes who may also be managing excess weight or insulin resistance. ​​When paired with diet, exercise, and other medications, GLP-1 treatment can help improve glycaemic control and long-term outcomes - and often leads to noticeable weight loss results^1,2.

Insulin directly lowers blood glucose and can be used at any stage of diabetes. People with type 1 diabetes rely on insulin therapy for treatment. 

GLP-1 medications, on the other hand, stimulate insulin production only when glucose is elevated, helping reduce the risk of low blood sugar (hypoglycaemia). ​​They also support appetite regulation and digestion, offering benefits beyond blood glucose control¹.

GLP-1 receptor agonists are commonly added to a diabetes treatment plan when other medications are no longer enough to maintain good control, or when patients require more insulin. They may be used alone or alongside other therapies, depending on the individual’s needs.

People using GLP1 injectable medications may experience a range of benefits, including:

• Lower fasting and post-meal blood glucose
• A reduction in HbA_1c (a marker of average blood sugar levels over time)
• ​​​Decreased appetite and modest or significant weight loss
• Cardiovascular protection with certain GLP-1 drugs^2,3

While results vary, many people find that GLP-1 therapy not only improves their glucose levels - but helps them feel fuller sooner and make more sustainable lifestyle changes.

Gastrointestinal side effects, which may be ​​categorised as adverse events, are the most common when starting GLP-1 therapy, especially during the first few weeks. These may include:

• ​Nausea and/or vomiting
• ​​​Diarrhoea
• Bloating or indigestion¹
• and other common side effects including headache, fatigue, and decreased appetite

These symptoms are typically mild and temporary, improving as the body adjusts to the medication. ​​Starting with a lower dose and gradually increasing it under medical supervision can help ​​minimise discomfort¹.

If symptoms like ​​diarrhoea, abdominal pain, or signs of kidney injury persist or become severe, it's important to discuss them with your doctor.

GLP-1 RAs are available in both injectable and oral forms. Some are taken daily, while others are administered weekly for added convenience.

• Metformin
• SGLT2 inhibitors
• Basal insulin

​​​They are generally not prescribed alongside DPP-4 inhibitors, as both types target the same hormonal pathway⁴. Your doctor will tailor the treatment combination based on your glucose levels, body weight, cardiovascular risk, and other health conditions.

​​​While GLP1 therapy is effective and widely used, it may not be recommended for people with:

• A personal or family history of medullary thyroid carcinoma
• Multiple endocrine neoplasia syndrome type 2 (MEN2)
• A history of pancreatitis or severe gastrointestinal disorders⁵

​As always, treatment decisions should be made in consultation with your doctor¹

​​​GLP-1 medications offer important blood sugar and appetite-regulating benefits, which can be enhanced with dietary changes. However, their full potential is unlocked when paired with healthy habits and ​​​​ongoing medical support^1,6.

To get the most from your diabetes treatment, you should:

• Eat well: balanced meals help control blood sugar and reduce side effects.
• Stay active: regular movement supports blood sugar and weight goals.
• Stick to your schedule: take your medication as prescribed.
• Drink plenty of water: staying hydrated helps manage digestion.
• Track your progress: keep an eye on symptoms and glucose levels.

​​​Keeping in close contact with your doctor is essential, especially for patients who may be at risk of heart failure. They can help tailor your diabetes treatment plan, manage side effects, and adjust the dose or medication type if needed⁷.

The way GLP-1 drugs work is gradual - most people see the greatest benefits after several weeks or months of consistent use.​​​​​​ Blood sugar levels may ​​stabilise first, followed by changes in appetite and the ability to lose weight. It’s also common for the treatment to be part of a longer-term plan, and other diabetes therapies including a balanced diet and exercise that is stepped up over time^2,8.

Having realistic expectations can make a big difference. While GLP-1 medications offer many benefits, including when taken on an empty stomach the effects vary from person to person. Some people see quicker improvements than others but sticking with the plan and building healthy habits alongside treatment often leads to better outcomes.

By understanding how GLP-1 works, staying informed, and working closely with your doctor, you can take an active role in your diabetes treatment. Whether you're newly diagnosed or living with diabetes— small, consistent steps can make a meaningful difference in your health and wellbeing.

GLP-1 receptor agonists (GLP-1 RAs) are mainly prescribed for people with type 2 diabetes and are not commonly used as a standard treatment for type 1 diabetes, since people with type 1 diabetes do not produce insulin and rely on insulin therapy as their primary treatment.

Yes, GLP-1 receptor agonists (GLP-1 RAs) can promote weight loss in many people. These medications mimic a natural hormone that helps regulate blood sugar and also affects appetite and digestion. By slowing down how quickly food leaves the stomach and increasing feelings of fullness, GLP-1 RAs can help reduce overall food intake.

The length of time you’ll need to take a GLP-1 receptor agonist (GLP-1 RA) depends on your doctor's assessment of your individual health needs and how well the medication helps manage your blood sugar. For some people, GLP-1 RAs are part of a long-term treatment plan, especially if they continue to provide benefits like improved blood sugar control, weight loss, or cardiovascular protection. Others may only need them temporarily, particularly if lifestyle changes lead to better blood sugar levels over time.

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