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Understanding GLP‑1 receptor agonists

Where do GLP-1 receptor agonists fit in with insulin and non-insulin diabetes treatments?

There are lots of different pills and injections for people with type 2 diabetes—and a GLP-1 receptor agonist (RA) is one you may not have heard of. But with a little background, you’ll be able to have a better talk with your doctor about what options may be right for you.

To start, there are 2 main types of diabetes medicines: non-insulin medicines and insulin. Some people take one, some people take the other, and some take both. Non-insulin medicinesNon-insulin medicinesMedication other than insulin that is taken orally or by injection to treat diabetes. can be pills that you take by mouth or injections given under the skin. InsulinInsulinA hormone made by the beta cells in the pancreas that helps glucose move from the blood into the cells. Insulin is also an injectable medicine that is used to treat diabetes by controlling the level of glucose in the blood. is usually injected.

So, what is GLP-1?

GLP-1 is short for glucagon-like peptide‑1. It's a natural hormone released from cells in the intestine. It works on your body in different ways, including helping your body release more insulin at mealtime to keep blood glucose in balance. If you have type 2 diabetes, your body may not be responding to GLP-1 properly. When your insulin isn't released at the right time or in the right amount, your blood glucose can get too high.

How does a GLP-1 receptor agonist work? 

A GLP-1 receptor agonist is a non-insulin medicine that acts like the GLP-1 in your body. The word agonist means that the drug or substance stimulates a response in your body by acting on a specific receptor. In type 2 diabetes, a GLP-1 receptor agonist works in a number of ways, some of which are:

pancreas type 2 diabetes
  • When blood glucose is high, the amount of insulin your pancreas releases after you eat is increased
liver type 2 diabetes
  • When blood glucose is high, the liver is stopped from making too much glucose
gut type 2 diabetes
  • Slows the emptying of the stomach’s contents into the intestines

Test your knowledge

Can I take a GLP-1 RA if I’m already on insulin?


Sorry, that's incorrect.

Like many diabetes treatments, most GLP-1 RAs can be taken in combination with insulin, other diabetes therapies, or alone. Work with your diabetes care team to determine the right kinds of medication for you and your body.

Who gets a GLP-1 receptor agonist?

While some people may need to be started on metformin as their first diabetes medication, and other people may be started on a GLP-1 receptor agonist prior to insulin, many people with type 2 diabetes need more than one medicine to help get their numbers where they should be. Many people with diabetes find that their needs change over time, even if they are doing everything right, and when this happens, your treatment plan may change, too. This doesn't mean that your diabetes is getting worse. It just means that your body is making less insulin. So, it's important to work with your diabetes care team to ensure that your treatment plan will work for you to provide the needed control.

Your diabetes care team may start you on a GLP-1 receptor agonist, either prior to or in conjunction with metformin for a few reasons.

Your doctor may feel it's a good choice because this type of medicine may help in patients with a need for additional glycemic control, weight considerations or a need to minimize hypoglycemia (low blood glucose) risk and improve control of blood glucose.

Additionally, certain kinds of GLP-1 receptor agonists may be an option for people with a high risk or history of cardiovascular disease, like heart attack or stroke.

Whether you’re already taking a GLP-1 receptor agonist, or you are thinking about it, be sure to ask your doctor any questions you may have.

You may also like:

Understanding insulin

Your guide to different kinds of insulin treatments.

Understanding non-insulin diabetes medications

Making sense of some of the most common non-insulin diabetes treatment options.

The diabetes puzzle

Have a closer look at how different parts of your body can contribute to the progress of type 2 diabetes.


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