Glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy in type 2 diabetes

Background Type 2 diabetes (T2D) is a national health priority. Its rising prevalence is accompanied by a high burden of diabetes-related complications, many of which are preventable. Numerous glucose-lowering medications have been developed in recent years with growing evidence relating to their efficacy and safety. These advances have increased the complexity of prescribing decisions in T2D. Objective This review provides clinicians with relevant evidence and practical advice concerning glucagon-like peptide-1 receptor agonists (GLP1-RAs) in T2D. Discussion The Royal Australian College of General Practitioners recommends GLP1-RAs as an option for second-line therapy in T2D. GLP1-RAs contribute to weight loss and glycated haemoglobin reduction. GLP1-RAs also reduce incidence of cardiovascular events in selected populations, and available evidence suggests renoprotective effects. Common adverse effects include gastrointestinal symptoms, especially in the weeks following treatment initiation. GLP1-RAs should be considered for people with T2D at high cardiovascular risk or where weight loss is a priority.