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Key takeaways
GLP-1 receptor agonists can help support healthy blood glucose levels and manage appetite with a range of approved indications.
Research suggests GLP-1 medications may treat kidney disease, neurodegenerative disorders, and gastrointestinal conditions, among other non-approved conditions.
Evidence also shows benefits for peripheral neuropathy and liver diseases via distinct pathways and mechanisms of action.
Pharmacists play a key role in educating patients on GLP-1 treatment, proper use, and potential side effects.
GLP-1 receptor agonists have greatly changed how we treat diabetes and obesity in recent years. Popular medications like Ozempic, Wegovy, and Zepbound have become popular not only for their ability to manage blood sugar levels but also for their impressive weight loss benefits.
Beyond diabetes and weight loss, the use of GLP-1 medications is expanding into treatment for kidney disease, peripheral neuropathy, and potentially even dementia. Over 400 clinical trials are currently testing GLP-1 treatments for various conditions. With a growing demand for GLP-1 agonists, pharmacists may help guide healthcare providers and patients about proper use, potential side effects, and what to expect.
Current approved uses of GLP-1 agonists
GLP-1 receptor agonists have gained FDA approval for several medical conditions. Their unique action in mimicking the GLP-1 hormone improves insulin secretion, suppresses glucagon release, and slows gastric emptying.
GLP-1 medications for Type 2 diabetes
Most GLP-1 agonists are primarily approved for managing Type 2 diabetes. These GLP-1 agonists include:
- Trulicity (dulaglutide)
- Byetta (exenatide)
- Bydureon (exenatide extended-release)
- Victoza (liraglutide)
- Adlyxin (lixisenatide)
- Ozempic (semaglutide)
- Rybelsus (semaglutide)
The drugs work best for managing glucose levels when combined with diet and exercise. Most patients see a significant drop in their A1C levels within three to six months of starting treatment, with many staying adherent after an early response.
Mounjaro (tirzepatide) is another similar option for Type 2 diabetes, but it is classified as a dual GIP/GLP-1 receptor agonist. While healthcare providers might not be prescribing these medications as a first-line treatment, some patients may benefit from a GLP-1 agonist as their first medication.
GLP-1 medications for weight loss
Wegovy (semaglutide) is FDA-approved for chronic weight management, as it helps patients feel full longer and manages appetite. Zepbound (tirzepatide) is another similar option to support weight loss in patients with obesity. Clinical trials have shown that patients can lose 15% to 20% of their body weight while taking these medications.
To qualify for these medications, patients must have:
- BMI ≥ 30, or
- BMI ≥ 27 with at least one weight-related condition
GLP-1 medications for cardiovascular risks
Recent studies show that GLP-1s can reduce heart attack and stroke risk in people with Type 2 diabetes. Victoza was the first GLP-1 approved to lower cardiovascular risks. Trulicity and Ozempic are other GLP-1 agonists approved for similar benefits.
GLP-1 medications for sleep apnea
Zepbound is the first medication approved for obstructive sleep apnea (OSA). It is specifically indicated for moderate to severe OSA in adults with obesity. Other GLP-1 agonists have shown promise in treating obstructive sleep apnea and may seek approval for this purpose. By promoting weight loss, these medications may help improve breathing during sleep.
GLP-1 medications for chronic kidney disease
One major potential use of GLP-1 agonists is protecting kidney function and slowing disease progression. Clinical trials show that GLP-1 medications may lower the risk of kidney failure and decrease cardiovascular events in patients with diabetes and kidney disease. The medications are believed to help reduce inflammation and improve blood flow to the kidneys.
A meta-analysis reviewed the effects of GLP-1 receptor agonists and found that compared to placebo, these GLP-1 drugs significantly reduced the risk of serious kidney complications by 18% and kidney failure by 16% in people with Type 2 diabetes. In addition, these agents also decreased the incidence of major cardiovascular events, including heart attacks and strokes, by 13%.
On Jan. 28, 2025, the FDA announced the approval of Ozempic for reducing the risk of worsening kidney disease and cardiovascular death in adults with chronic kidney disease and Type 2 diabetes.
Potential expanded uses of GLP-1 agonists
New research suggests that GLP-1 agonists can help treat conditions beyond their approved uses. Researchers are finding these medications could help with brain health, liver problems, and several other medical conditions.
Neurodegenerative conditions
GLP-1 agonists show promise as neuroprotective agents by improving memory and neuronal survival. Studies in Alzheimer’s models show protection against amyloid beta-induced impairment. Their activation of cAMP/PKA pathways in the hippocampus supports cell growth and repair, suggesting benefits for cognitive decline linked to Type 2 diabetes. This new evidence could allow us to use these agents to slow neurodegeneration in Alzheimer’s patients.
In Parkinson’s disease models, GLP-1 agonists like exendin-4 have been found to protect dopaminergic neurons, improving motor function and reducing toxin-induced damage. Early findings in Huntington’s disease also indicate improvements in insulin sensitivity and reduced oxidative stress, which could slow disease progression.
Peripheral neuropathy
GLP-1 receptor agonists have also been studied in treating diabetic peripheral neuropathy (DPN) in patients with Type 2 diabetes. A recent study with 24 participants revealed significant improvements in clinical neuropathy scores and nerve conduction over a three-month period.
These medications appear to improve how axons work by boosting the activity of the Na+/K+-ATPase pump and changing sodium permeability. Research on axonal excitability, backed by mathematical models, has confirmed these changes and indicated that they may reverse axonal dysfunction. Therefore, GLP-1 agonists could be a promising treatment option to manage the progressive nature of DPN, a condition that has usually been seen as irreversible.
Gastrointestinal diseases
GLP-1 receptor agonists may become potential treatments for gastrointestinal diseases due to their anti-inflammatory and gut-protective properties. Inflammatory bowel disease (IBD) studies suggest that GLP-1 agonists promote mucosal healing and reduce proinflammatory cytokines. Small-scale trials have shown promising results, but further research is needed to determine optimal dosing and long-term efficacy.
Beyond IBD, GLP-1 agonists may benefit conditions like short bowel syndrome (SBS) and chemotherapy-induced mucositis by slowing gastric emptying and improving intestinal absorption. Early studies indicate that combining GLP-1 and GLP-2 agonists may improve gut healing while reducing adverse effects like nausea and weight loss. As research progresses, these therapies could expand treatment options for chronic gastrointestinal disorders.
Liver disease
GLP-1 receptor agonists may have promising effects for metabolic dysfunction-associated steatotic liver disease (MASLD) by targeting both glycemic control and weight reduction. Their ability to lower HbA1c and promote weight loss not only benefits Type 2 diabetes and obesity management but also appears to reduce fat deposits in the liver.
Recent research is looking into new dual or triple hormonal agonists to improve outcomes for patients. As studies continue, these advanced treatments might provide more effective options for people living with both metabolic issues and liver problems.
Polycystic ovary syndrome (PCOS)
Studies have shown that GLP-1 agonists may help manage metabolic problems in PCOS. One systematic review and meta-analysis found that, when used alongside standard treatments, these medications can significantly reduce body weight, BMI, and waist circumference. They also improve insulin sensitivity in women with PCOS, as shown by lower insulin resistance index (HOMA-IR) scores and fasting blood glucose.
In addition, while GLP-1 agonists help address metabolic challenges, orlistat also has a role in lowering testosterone levels and improving lipid profiles in PCOS. Therefore, different pharmacological options may be used together to target the various aspects of the condition, including hyperandrogenism and dyslipidemia. As research continues, incorporating GLP-1 receptor agonists could be a treatment strategy for women with PCOS.
RELATED: Wegovy for PCOS
Keeping patients and healthcare providers up to date
With digital health platforms making GLP-1 therapies more accessible, pharmacists now play an even more important role in patient care when it comes to these medications. They have the expertise to explain key details—like proper injection techniques, side effects, and new indications—to patients and fellow healthcare providers.
By tracking how patients respond, answering questions as they come up, and staying on top of the latest safety information, pharmacists can help ensure these medications deliver real benefits. Their involvement may drive better patient outcomes for a variety of conditions, including diabetes, obesity, sleep apnea, chronic kidney disease, and others that are still being explored. As the use of GLP-1 agonists expands, so will the opportunities for pharmacists to make an even greater impact.
Sources
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- FDA approves first medication for obstructive sleep apnea, U.S. Food and Drug Administration (2024)
- GLP-1 receptor agonists in diabetic kidney disease: current evidence and future directions, Kidney Research and Clinical Practice (2022)
- Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trials, The Lancet Diabetes & Endocrinology (2025)
- Press Release: FDA approves Ozempic (semaglutide) as the only GLP-1 RA to reduce the risk of worsening kidney disease and cardiovascular death in adults with Type 2 diabetes and chronic kidney disease, Novo Nordisk (2025)
- Recent advances and therapeutic benefits of glucagon-like peptide-1 (GLP-1) agonists in the management of type 2 diabetes and associated metabolic disorders, Cureus (2024)
- Impact of glucagon-like peptide-1 receptor agonists on axonal function in diabetic peripheral neuropathy, Journal of Neurophysiology (2025)
- GLP-1 and intestinal diseases, Biomedicines (2021)
- Glucagon like peptide-1 receptor agonists as a promising therapeutic option of metabolic dysfunction associated steatotic liver disease and obesity: hitting two targets with one shot, Current Opinion in Gastroenterology (2025)
- Comparative efficacy of pharmacological interventions on metabolic and hormonal outcomes in polycystic ovary syndrome: a network meta-analysis of randomized controlled trials, BMC Women’s Health (2025)