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Review
. 2021 Oct 17:14:11795514211051697.
doi: 10.1177/11795514211051697. eCollection 2021.

Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Hypoglycemia

Daria Ja'arah  1 , Mazhar Salim Al Zoubi  1 , Gamal Abdelhady  1 , Firas Rabi  2 , Murtaza M Tambuwala  3
Affiliations
Review

Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Hypoglycemia

Daria Ja'arah et al. Clin Med Insights Endocrinol Diabetes. .

Abstract

A relatively recent addition to the arsenal of antidiabetic drugs used for the treatment of type 2 diabetes mellitus (T2DM) has been the "incretin mimetics," a group of drugs that work on the glucagon-like peptide-1 (GLP-1) receptor and enhance insulin secretion from the pancreatic β-cells in a glucose-dependent manner, more potently in hyperglycemic conditions, while suppressing glucagon secretion at the same time. Therefore, it was assumed that this class of drugs would have a lower risk of hypoglycemia than insulin secretagogues like sulphonylureas. However, GLP-1 receptor agonists have been proposed to cause hypoglycemia in healthy normoglycemic subjects implying that their action is not as glucose-dependent as once thought. Other studies concluded that they might not induce hypoglycemia and the risk is dependent on other individual factors. However, the FDA announced that the 12 GLP-1 receptor agonists currently available on the market had potential safety signs and evaluated the need for regulatory action. This review provides an overview of the studies that investigated the possible hypoglycemic effect of GLP-1 receptor agonists. In addition, the current review describes other adverse effects of GLP-1 receptor agonist treatment.

Keywords: GLP-1; GLP-1 RA; T2DM; hypoglycemia.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Schematic of action of GLP-1 on insulin secretion.
Figure 2.
Figure 2.
Schematic of proposed mechanism of hypoglycemia in GLP-1 receptor agonists.
See this image and copyright information in PMC

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