title: GLP-1R agonist therapy for diabetes:  benefits and potential risks.
abstract: OBJECTIVE
  Glucagon-like peptide 1 receptor (GLP-1R) agonists provide good glycemic control combined with low hypoglycemia risk and weight loss. Here, we summarize the recently published data for this therapy class, focusing on sustainability of action, use in combination with basal insulin, and the efficacy of longer acting agents currently in development. The safety profile of GLP-1R agonists is also examined.
  
  
  RESULTS
  GLP-1R agonists provide sustained efficacy and their combination with basal insulin is well tolerated, providing additional glycemic control and weight benefits compared with basal insulin alone. Data suggest that the convenience of longer acting agents may be at the expense of efficacy. Despite the initial concerns, most evidence indicates that GLP-1R agonists do not increase the risk of pancreatitis or thyroid cancer. However, the extremely low incidence of these events means further investigations are required before a causal link can be eliminated. Large-scale clinical trials investigating the long-term cardiovascular safety of this therapy class are ongoing and may also provide important insights into pancreatic and thyroid safety.
  
  
  CONCLUSIONS
  GLP-1R agonists offer sustained glycemic efficacy, weight loss benefits, and a low risk of hypoglycemia. The results of ongoing trials should help to clarify the safety of this therapy class.
authors: Baylor College of Medicine, Houston, Texas, USA. ssamson@bcm.edu
authors: Susan L
authors: SL
authors: Samson
authors: Alan
authors: A
authors: Garber
mesh_terms: D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000139:chemically induced*; D000077270:Exenatide; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000819:agonists* / Q000031:analogs & derivatives / Q000627:therapeutic use; D004763:Glucagon-Like Peptides / Q000031:analogs & derivatives; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007141:Immunoglobulin Fc Fragments / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D000069450:Liraglutide; D008297:Male; D010195:Pancreatitis / Q000139:chemically induced*; D010455:Peptides / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000139:chemically induced*; D016896:Treatment Outcome; D014688:Venoms / Q000627:therapeutic use; D000067758:Glucagon-Like Peptide-2 Receptor
chemical_list: D001786:Blood Glucose; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D004763:Glucagon-Like Peptides; D007004:Hypoglycemic Agents; D007141:Immunoglobulin Fc Fragments; D007328:Insulin; D000069450:Liraglutide; D010455:Peptides; D011993:Recombinant Fusion Proteins; D014688:Venoms; C534611:rGLP-1 protein; C479460:lixisenatide; D000067758:Glucagon-Like Peptide-2 Receptor; C555680:dulaglutide