From the Guidelines
GLP-1 mimickers, also known as GLP-1 receptor agonists, are medications that mimic the action of the naturally occurring hormone glucagon-like peptide-1, with semaglutide and liraglutide being prominent examples, as evidenced by a 2023 review in JAMA 1.
Key Characteristics of GLP-1 Mimickers
- These medications are primarily used for treating type 2 diabetes and, more recently, for weight management.
- Common GLP-1 mimickers include semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), dulaglutide (Trulicity), tirzepatide (Mounjaro), and exenatide (Byetta, Bydureon).
- They work by stimulating insulin secretion when blood glucose is high, suppressing glucagon release, slowing gastric emptying, and reducing appetite through effects on the brain's satiety centers.
Administration and Side Effects
- For diabetes management, typical starting doses are lower (e.g., semaglutide 0.25mg weekly, increasing gradually), while weight management often requires higher doses (e.g., semaglutide up to 2.4mg weekly for Wegovy).
- These medications are administered by subcutaneous injection, with frequencies ranging from twice daily to once weekly depending on the specific drug.
- Common side effects include nausea, vomiting, diarrhea, and constipation, which often improve over time.
- Patients should be aware that these medications may affect the absorption of oral medications due to delayed gastric emptying, and they should monitor for rare but serious side effects such as pancreatitis or thyroid issues.
Clinical Evidence and Recommendations
- A 2023 review in JAMA 1 highlights the efficacy of semaglutide and liraglutide in weight management and their potential to reduce cardiovascular risk.
- The 2025 standards of care in diabetes published in Diabetes Care 1 recommend the use of a glucagon-like peptide 1 agonist with demonstrated benefit to reduce cardiovascular risk and kidney disease progression in people with type 2 diabetes and chronic kidney disease.
- Given the most recent and highest quality evidence, semaglutide and liraglutide are the preferred GLP-1 mimickers for both diabetes management and weight loss, due to their proven efficacy and safety profiles, as supported by the 2023 JAMA review 1.
From the FDA Drug Label
VICTOZA contains liraglutide, an analog of human GLP-1 and acts as a GLP-1 receptor agonist Liraglutide is an acylated human Glucagon-Like Peptide-1 (GLP-1) receptor agonist with 97% amino acid sequence homology to endogenous human GLP-1(7-37)
- A GLP-1 mimicker is a substance that mimics the action of Glucagon-like peptide-1 (GLP-1), a natural hormone in the body.
- Liraglutide and semaglutide are examples of GLP-1 mimickers, which are used to treat type 2 diabetes mellitus by activating the GLP-1 receptor and increasing insulin release in the presence of elevated glucose concentrations 2, 2, 3.
From the Research
Definition of GLP-1 Mimicker
A GLP-1 mimicker, also known as a GLP-1 receptor agonist, is a type of medication that mimics the effects of the incretin hormone GLP-1, which is released from the intestine in response to food intake 4.
Mechanism of Action
These medications work by increasing insulin secretion, decreasing glucagon release, increasing satiety, and slowing gastric emptying, thereby improving blood glucose control and having other potential benefits such as preserving beta-cell function, weight loss, and increasing insulin sensitivity 4, 5.
Types of GLP-1 Mimickers
There are several types of GLP-1 receptor agonists available, including:
Benefits and Uses
GLP-1 receptor agonists have been shown to be effective in improving blood glucose control, facilitating weight loss, and having cardioprotective effects 4, 5, 7, 8. They are also associated with a low risk of hypoglycemia and may have renoprotective properties, making them a potential treatment option for people living with type 2 diabetes mellitus and chronic kidney disease 7, 8.
Administration
GLP-1 receptor agonists can be administered subcutaneously or orally, with the oral formulation of semaglutide being the first oral GLP-1 receptor agonist reviewed by the U.S. Food and Drug Administration (FDA) 5. Once-weekly formulations are also available, which may improve patient adherence 4, 6.