The Impact of Glp-1 Receptor Agonists and Non-Injectable Therapies on Glycemic and Weight Management in Type 2 Diabetes Mellitus Patients Publisher



Sharifi M ; Moludi J ; Mazaheritehrani S ; Jamshidi Mahmoud Abadi Z ; Alihalvae N
Source: Journal of Isfahan Medical School Published:2025

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a common chronic disease affecting adults worldwide. In recent years, significant advancements have been made in its treatment, including the introduction of glucagon-like peptide1 receptor agonists (GLP-1 RAs) and non-injectable therapies. These treatments play a crucial role in glycemic control and the management of metabolic disorders associated with diabetes. However, the results of randomized controlled trials (RCTs) on the effects of GLP-1 RAs on HbA1c and weight loss in T2DM patients have not been consistent or conclusive.Therefore, conducting a systematic review to summarize and critically evaluate the existing. evidence in this field is essential. Methods: We conducted a strategic search of PubMed, Scopus, Embase, ProQuest, and Google Scholar databases from inception to January 2025. The inclusion criteria were all RCTs in English‐language journals on T2DM that were intervened with GLP-1 RAs.T he Critical Appraisal Skills Program (CASP) checklist was used to assess the quality of included articles. Findings: Out of 574 reviewed articles, only 17 met the inclusion criteria. The findings of this study indicate that Tirzepatide has the most effective role in reducing HbA1c and fasting plasma glucose concentrations (MD-1.50%, and-3.19 mmol/L), while CagriSema resulted in the highest weight loss (MD-4.73 kg) compared to other types of GLP-1 Ras in T2DM patients. Nevertheless, the majority of trials highlighted gastrointestinal risks associated with GLP-1Ras, emphasizing the need for safety, particularly with high-dose regimens. Conclusion: The beneficial effects of GLP-1Ras on glycemic control and weight loss make them a first-line therapy for individuals with obesity and T2DM. However, further trials are needed to determine the optimal dosing and duration of treatment. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.