A 2021 Update on the Use of Liraglutide in the Modern Treatment of ‘Diabesity’: A Narrative Review

Abstract

Obesity and type 2 diabetes mellitus have become a significant public health problem in the past decades. Their prevalence is increasing worldwide each year, greatly impacting the economic and personal aspects, mainly because they frequently coexist, where the term “diabesity” may be used. The drug class of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) is one of the most modern therapy options in managing these metabolic disorders. This review focuses on the effects of liraglutide, a long-acting GLP-1 RA, in diabesity and non-diabetic excess weight. This drug class improves glycemic control by enhancing insulin secretion from the beta-pancreatic cells and inhibiting glucagon release. Furthermore, other effects include slowing gastric emptying, increasing postprandial satiety, and reducing the appetite and food consumption by influencing the central nervous system, with weight reduction effects. It also reduces cardiovascular events and has positive effects on blood pressure and lipid profile. A lower-dose liraglutide (1.2 or 1.8 mg/day) is used in patients with diabetes, while the higher dose (3.0 mg/day) is approved as an anti-obesity drug. In this review, we have summarized the role of liraglutide in clinical practice, highlighting its safety and efficacy as a glucose-lowering agent and a weight-reduction drug in patients with and without diabetes.

The Obese Brain: Mechanisms of Systemic and Local Inflammation, and Interventions to Reverse the Cognitive Deficit

“…Moreover, when the drug was combined with physical activity, it significantly increased weight loss compared to liraglutide alone or physical exercise alone. These results reinforce the benefits of liraglutide in weight loss and emphasize the fundamental role of physical activity in chronic weight control ( Lundgren et al, 2021 ; Tilinca et al, 2021 ).…”

Satiety: a gut–brain–relationship

“…Neuronal circuits are activated, and food intake declines as satiety signals like CCK and GLP-1 are created during food ingestion, signaling the conclusion of the meal. Finally, GLP-1 injections into the body over an extended period of time decrease weight gain and promote weight loss [ 23 ]. This is also supported by the observation that obese people have lower GLP-1 levels than lean people [ 24 ].…”

Effect of Liraglutide on Fat Mass Percentage Among Overweight and Obese Adults with Type 2 Diabetes: A Systematic Review

“…In fact, between 1975 and 2016, the rate of obesity tripled and continuously escalated in pandemic-like proportions. 1 In 2016 alone, data from the World Health Organization (WHO) revealed that more than 1.9 billion adults aged 18 years and above were overweight, 650 million of whom were obese. The prevalence of overweight and obesity is reported to be higher in women than in men across the globe, in both developed and developing countries.…”