GLP-1 as a target for therapeutic intervention

Glucagon-like peptide receptor agonists (GLP-1 RA) have multiple effects, including control of glycaemia via stimulation of insulin and suppression of glucagon secretion and reduction of adiposity by enhancing satiety, so are an attractive therapeutic option in type 2 diabetes management. Five GLP-1 RA are used currently and more are in development. The HbA1c reduction obtained varies from 1 to 2%; they reduce body weight by about 2–3 kg when used to treat T2DM, while liraglutide results in greater weight loss at a higher dose and has recently been approved for the management of obesity. GLP-1 RA are usually used in combination with other glucose-lowering drugs, but dual combinations with basal insulin in a single injection have recently become available. The next decade is likely to see the development of more potent and longer lasting agents as well as hybrid molecules with dual or triple actions.