GLP‑1 receptor agonists, the popular drugs for treating diabetes and obesity, not only help with weight loss but may also reduce the risk of serious infections, fractures, dementia, and respiratory diseases. However, side effects were also present: the main ones were gastrointestinal—nausea, vomiting and diarrhoea. These conclusions come from Chinese scientists who pooled data from 60 meta-analyses covering 1,751 clinical studies involving more than 3.5 million people. The results have been published in JAMA Network Open.
Researchers led by Li Yongze from the China Medical University assessed a wide range of effects of glucagon-like peptide‑1 (GLP‑1) receptor agonists used in the treatment of type 2 diabetes and obesity.
The analysis confirmed that the most common adverse effects are gastrointestinal. Treatment significantly increased the likelihood of nausea, vomiting and diarrhoea. For nausea and diarrhoea, the quality of evidence was high. At the same time, data on risks to the pancreas and gallbladder did not meet strict criteria for conclusiveness.
In addition, the researchers identified several potential pleiotropic effects. Use of GLP‑1 agonists was associated with a reduced risk of serious infections, as well as a moderate protective effect against fractures, respiratory diseases and dementia. At the same time, an increased risk of thyroid disease was noted, though the significance of some of these findings remains limited.
No convincing evidence was found linking the drugs to cancer outcomes. Individual signals, including a possible increased risk of colorectal cancer and a decreased risk of pancreatic cancer, were considered preliminary. The authors emphasise that current data are insufficient for definitive conclusions about non‑metabolic effects and call for further research and a more personalised approach to therapy.
GLP‑1 receptor agonists are considered a cornerstone of therapy for type 2 diabetes and obesity, but their effects are not limited to metabolic processes. Previous evidence has confirmed their benefits for the cardiovascular system and kidneys, as well as a therapeutic effect in alcohol use disorders. Furthermore, researchers at the Karolinska Institutet published a cohort study in The Lancet Psychiatry showing that use of semaglutide and liraglutide is associated with a reduced risk of worsening symptoms of depression and anxiety in patients with diabetes and obesity.