Which medications in the drug class Antidiabetics, Glucagon-like Peptide-1 Agonists are used in the treatment of Metabolic Syndrome?

Updated: Mar 30, 2020
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

Antidiabetics, Glucagon-like Peptide-1 Agonists

Glucagonlike peptide–1 (GLP-1) agonists mimic the endogenous incretin GLP-1, stimulating glucose-dependent insulin release (as opposed to oral insulin secretagogues, which may cause non–glucose-dependent insulin release and hypoglycemia), reducing glucagon, and slowing gastric emptying.

Evidence from the LEADER clinical trial resulted in liraglutide’s approval for risk reduction of major cardiovascular (CV) events (CV death, nonfatal myocardial infarction [MI], and nonfatal stroke) in adults with type 2 diabetes mellitus (T2DM) and established CV disease. [133]

Similarly, once weekly semaglutide SC is also indicated for CV risk reduction in adults with T2DM and heart disease. Results from the SUSTAIN 6 clinical trial (N = 3297) showed that patients treated with semaglutide SC had a significant 26% lower risk for the primary composite outcome of first occurrence of CV death, nonfatal MI, or nonfatal stroke compared with placebo. [134]

Liraglutide (Victoza)

Liraglutide is a once-daily SC injectable GLP-1 receptor agonist that stimulates G-protein in pancreatic beta cells. It increases intracellular cyclic adenosine monophosphate (cAMP), leading to insulin release in the presence of elevated glucose concentrations. Liraglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Additionally, it is indicated to reduce the risk of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease.

Semaglutide (Ozempic)

When blood glucose is high, semaglutide, a GLP-1 receptor agonist, lowers it by stimulating insulin secretion and reducing glucagon secretion. Additionally, the once-weekly SC product is also indicated for cardiovascular risk reduction in adults with T2DM and heart disease.

Dulaglutide (Trulicity)

Dulaglutide is a glucagonlike peptide-1 (GLP-1) agonist that acts as an incretin mimetic. It increases insulin secretion in the presence of elevated blood glucose, delays gastric emptying to decrease postprandial glucose, and decreases glucagon secretion. It is administered as a once-weekly SC injection. It is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also indicated to reduce risk of major adverse cardiovascular (CV) events (CV death, nonfatal MI, or nonfatal stroke) in adults with T2DM who have established CV disease or multiple CV risk factors.


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