Skip to main content

05-04-2018 | GLP-1 agonists | Review | Article

Glucagon-like peptide 1 in health and disease

Nature Reviews Endocrinology

Authors: Andreas Andersen, Asger Lund, Filip K. Knop, Tina Vilsbøll

Publisher: Nature Publishing Group UK


In healthy individuals, the incretin hormone glucagon-like peptide 1 (GLP1) potentiates insulin release and suppresses glucagon secretion in response to the ingestion of nutrients. GLP1 also delays gastric emptying and increases satiety. In patients with type 2 diabetes mellitus (T2DM), supraphysiological doses of GLP1 normalize the endogenous insulin response during a hyperglycaemic clamp. Owing to the short plasma half-life of native GLP1, several GLP1 receptor agonists (GLP1RAs) with longer half-lives have been developed for the treatment of T2DM. These compounds vary in chemical structure, pharmacokinetics and size, which results in different clinical effects on hyperglycaemia and body weight loss; these variations might also explain the difference in cardiovascular effect observed in large-scale cardiovascular outcome trials, in which certain GLP1RAs were shown to have a positive effect on cardiovascular outcomes. Owing to their metabolic effects, GLP1RAs are also considered for the treatment of several other lifestyle-induced conditions, such as obesity, prediabetes and liver disease. This Review provides insights into the physiology of GLP1 and its involvement in the pathophysiology of T2DM and an overview of the currently available and emerging GLP1RAs. Furthermore, we review the results from the currently available large-scale cardiovascular outcome trials and the use of GLP1RAs for other indications.

Please log in to get access to this content

Related topics

CME-accredited GLP-1RAs webcast

Learn more about GLP-1RAs with John Wilding, Julie Lovshin and Kamlesh Khunti

CME-accredited GLP-1RAs webcast on real-world data

Led by Melanie Davies, Stewart Harris & Takashi Kadowaki, this on-demand webcast focuses on treatment with GLP-1RAs, based on real-world data, and the emerging landscape of GLP-1RAs in the context of approved guidelines.

Image Credits