Fast Five Quiz: Type 2 Diabetes Incretin-Based Therapy

Romesh Khardori, MD, PhD


June 24, 2021

GLP-1 receptor agonists may be more appropriate than DPP-4 inhibitors when weight loss or greater reductions in A1c are treatment priorities. GLP-1 receptor agonists confer weight loss and blood pressure effects that may contribute to long-term cardiovascular efficacy. GLP-1 also inhibits glucagon secretion, decreases gastric emptying, and reduces appetite through central nervous system pathways. Compared with insulin regimens that may cause weight gain, GLP-1 receptor agonists often result in substantial weight loss, and exogenous administration of GLP-1 has become a widely utilized strategy to lower glucose and weight.

SGLT2 inhibitors have natriuretic and osmotic diuretic effects, whereas GLP-1 receptor agonists have natriuretic and vasodilating effects.

Whereas long-acting GLP-1 receptor agonists are more effective than short-acting agents in A1c lowering, both types confer a similar weight loss benefit.

Combination therapy with GLP-1 receptor agonists and SGLT2 inhibitors lowers glycemic control but has neutral effects on body weight and systolic blood pressure.

Learn more about type 2 diabetes guidelines.


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