From the FDA Drug Label
Gastrointestinal: ileus Gastrointestinal: Acute pancreatitis, hemorrhagic and necrotizing pancreatitis sometimes resulting in death, ileus The FDA drug label does mention gastrointestinal side effects for GLP-1 receptor agonists, including ileus and acute pancreatitis.
- Key gastrointestinal side effects include ileus and acute pancreatitis.
- The label also mentions that lipase and amylase increases were observed in patients treated with dulaglutide and liraglutide, but the clinical significance of these findings is unknown 1 2. However, it is essential to note that the label does not provide a direct comparison of the gastrointestinal side effects of GLP-1 receptor agonists to other medications or a non-medicated state.
From the Research
GLP-1 medications are generally safe for most patients when prescribed appropriately, though they can cause gastrointestinal side effects, and their benefits for managing diabetes and weight often outweigh the temporary digestive discomfort for most patients. These medications work by mimicking a hormone that regulates blood sugar and appetite, slowing stomach emptying and increasing feelings of fullness. Common side effects include nausea, vomiting, diarrhea, and constipation, which typically improve over time as the body adjusts to the medication. Starting with a low dose and gradually increasing it helps minimize these effects. According to a recent study 3, GLP-1 receptor agonists have been shown to be effective in reducing HbA1c levels and body weight, with some agents, such as semaglutide, demonstrating greater efficacy. While your neighbor's concern about "stomach" issues has some basis, these medications have been thoroughly studied and approved by regulatory agencies. As an NP, you likely understand that individual responses vary, and these medications aren't appropriate for everyone, particularly those with certain gastrointestinal conditions like gastroparesis or inflammatory bowel disease.
Some key points to consider when prescribing GLP-1 medications include:
- Their ability to slow gastric emptying and increase feelings of fullness, which can lead to weight loss and improved glycemic control
- The potential for gastrointestinal side effects, which can be minimized by starting with a low dose and gradually increasing it
- The importance of individualizing treatment and monitoring patients for potential adverse effects
- The benefits of GLP-1 medications in reducing the risk of cardiovascular events and renal complications in patients with type 2 diabetes, as shown in studies such as 3 and 4.
Overall, the benefits of GLP-1 medications for managing diabetes and weight often outweigh the potential risks and side effects, making them a valuable treatment option for many patients.