The impact of GLP-1 Receptor Agonists and non-injectable Therapies on Glycemic and Weight Management in Type 2 Diabetes Mellitus Patients

Document Type : 6th congress of endocrinology & metabolism

Authors

1 MSc, Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a common chronic disease affecting adults worldwide. In recent years, significant advancements have been made in its treatment, including the introduction of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and non-injectable therapies. These treatments play a crucial role in glycemic control and the management of metabolic disorders associated with diabetes. However, the results of randomized controlled trials (RCTs) on the effects of GLP-1 RAs on HbA1c and weight loss in T2DM patients have not been consistent or conclusive.Therefore, conducting a systematic review to summarize and critically evaluate the existing evidence in this field is essential..
Methods: We conducted a strategic search of PubMed, Scopus, Embase, ProQuest, and Google Scholar databases from inception to January 2025. The inclusion criteria were all RCTs in English‐language journals on T2DM that were intervened with GLP-1 RAs. The Critical Appraisal Skills Program (CASP) checklist was used to assess the quality of included articles.
Findings: Out of 574 reviewed articles, only 17 met the inclusion criteria. The findings of this study indicate that Tirzepatide has the most effective role in reducing HbA1c and fasting plasma glucose concentrations (MD -1.50%, and -3.19 mmol/L), while CagriSema resulted in the highest weight loss (MD -4.73 kg) compared to other types of GLP-1 Ras in T2DM patients. Nevertheless, the majority of trials highlighted gastrointestinal risks associated with GLP-1Ras, emphasizing the need for safety, particularly with high-dose regimens.
Conclusion: The beneficial effects of GLP-1Ras on glycemic control and weight loss make them a first-line therapy for individuals with obesity and T2DM. However, further trials are needed to determine the optimal dosing and duration of treatment.

Highlights

Maryam Sharifi: PubMed, Google Scholar

Jalal Moludi: Google Scholar 

Sadegh Mazaheri-Tehrani: Google Scholar 

Keywords

Main Subjects

References

  1. Khunti K, Zaccardi F, Amod A, Aroda VR, Aschner P, Colagiuri S, et al. Glycaemic control is still central in the hierarchy of priorities in type 2 diabetes management. Diabetologia 2025; 68(1): 17-28.
  2. Rosenstock J, Frias J, Jastreboff AM, Du Y, Lou J, Gurbuz S, et al. Retatrutide, a GIP, GLP-1 and glucagon receptor agonist, for people with type 2 diabetes: a randomised, double-blind, placebo and active-controlled, parallel-group, phase 2 trial conducted in the USA. Lancet 2023; 402(10401): 529-44.
  3. Garvey WT, Frias JP, Jastreboff AM, le Roux CW, Sattar N, Aizenberg D, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 2023; 402(10402): 613-26.
  4. Blüher M, Rosenstock J, Hoefler J, Manuel R, Hennige AM. Dose-response effects on HbA(1c) and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial. Diabetologia 2024; 67(3): 470-82.
Journal of Isfahan Medical School
Volume 43, Issue 827
3rd Week, October: 6th International and 8th Iranian Congress of Endocrinology & Metabolism Updates
September and October 2025
Pages 992-994

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History

  • Receive Date: 31 May 2025
  • Revise Date: 15 July 2025
  • Accept Date: 16 June 2025

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