Integrating High-Dose GLP-1 Receptor Agonists Into the Care of People With or at Risk for Type 2 Diabetes

ABSTRACT

According to the 2019 Centers for Disease Control and Prevention (CDC) Diabetes Report Card, the proportion of US adults living with diabetes has steadily increased since 1999, and in the last decade, the number of adults with diabetes has almost doubled. Excess weight contributes to insulin resistance and is the major factor driving the increasing prevalence of type 2 diabetes in the US. In fact, a recent study by researchers at Northwestern University School of Medicine, which examined National Health and Nutrition Survey and Multi-Ethnic Study of Atherosclerosis data from 2000 to 2017, estimates 30% to 53% of incident diabetes in the US can be attributed to obesity.Unfortunately, a high percentage of US adults are overweight and obese. Currently, the CDC estimates that 3 of every 4 US adults has a BMI greater than 25 kg/m2. People with obesity are more likely to develop metabolic conditions and are at an increased risk for serious illness from acute causes, such as coronavirus disease (COVID-19). Because of the high association of obesity with type 2 diabetes, efforts that address both conditions should be a priority for US health care providers. Until recently, highly effective drug therapy options were limited by narrow therapeutic windows and/or poor effectiveness.The purpose of this review is to provide an update on emerging data for high-dose glucagon-like peptide (GLP-1) receptor agonists to treat overweight or obesity in those at risk for or diagnosed with diabetes.