Oral Presentation ESA-SRB-AOTA 2019

Using GLP-1 receptor agonists to improve health outcomes for people with type 2 diabetes  (#27)

Richard MacIsaac 1
  1. Endocrinology and Diabetes, St Vincent's Hospital & University of Melbourne, Fitzroy, Victoria, Australia

Glucagon-like peptide 1 (GLP-1) is a gut-derived incretin-hormone that is released in response to eating. Its actions include appetite control, glucose-dependent secretion of insulin and inhibition of glucagon secretion. GLP-1 receptor agonists (GLP-1RAs) have been developed to enhance the incretin effect and have been shown to reduce fasting and post-prandial glucose levels, HbA1c values, blood pressure and weight. The most common side effect of GLP-1RA use is nausea which usually decreases over time. The beneficial effects of some (liraglutidesemaglutidealbiglutide, and dulaglutidebut not all (lixisenatide and extended-release exenatideGLP-1RAalso extend to the cardiovascular (CV) system. Possibly, the differences in CV outcomes observed in clinical trials with various GLP-1RAs relates to their molecular structure and half-life, but differences in trial design and conduct may also be possible explanations. The exact mechanisms whereby some GLP-1RAs reduce CV events remains unknown but may be due to improved metabolic control, an anti-atherogenic effect and modulation of inflammatory pathways. Furthermore, GLP-1RAs reduce albuminuria and may slow down the progression of renal function loss, but their long-term effects on renal outcomes remains unknown. This presentation will highlight our current understanding of the potential metabolic, CV and renal benefits of the GLP-1RAs.