Understanding GLP-1 Agonist Side Effects and Risks

May 9, 2025

Are you taking a GLP-1 agonist to manage type 2 diabetes? While these medications promise to improve blood sugar control and aid weight loss, you might also face unexpected challenges in the form of nausea or vomiting. Do GLP-1 agonists have side effects? Does taking these medications lead to health complications?

This blog is your guide to understanding what GLP-1 agonists are and their beneficial effects on the body. You will also learn the potential side effects and risks you should consider before or while taking these medications.

So, let’s make your health journey as beneficial and stress-free as possible!

What are GLP-1 agonists?

GLP-1 agonists are a class of prescription medications that work by mimicking the action of a naturally occurring hormone in your body called glucagon-like peptide-1 (GLP-1). The natural GLP-1 hormone regulates blood sugar levels and promotes feelings of fullness after meals. Due to their mimicking actions, agonists are widely used in the treatment of type 2 diabetes and obesity.

GLP-1 agonists are also known by other names:

Glucagon-like peptide-1 receptor agonists
incretin mimetics
GLP-1 receptor agonists
GLP-1 analogs

These medications are FDA-approved and have undergone rigorous testing to demonstrate their safety and effectiveness for specific purposes, mainly for managing type 2 diabetes and obesity.

Popular GLP-1 agonist medications

GLP-1 agonists are gaining popularity as their potential applications expand. Here's a list of some commonly prescribed GLP-1 agonists in India and globally:

Generic Name	Brand Name	Approved Use
Semaglutide injection	Ozempic	Type 2 diabetes
Semaglutide injection	Wegovy	Weight loss
Semaglutide tablets	Rybelsus	Type 2 diabetes
Liraglutide	Victoza	Type 2 diabetes
Liraglutide	Saxendra	Weight loss
Tirzepatide	Mounjaro	Type 2 diabetes
Tirzepatide	Zepbound	Weight loss
Dulaglutide	Trulicity	Type 2 diabetes
Exenatide	Byetta	Type 2 diabetes
Exenatide extended release	Bydureon	Type 2 diabetes

Now, let's explore how these medications work their magic in your body!

How do GLP-1 agonists work?

Understanding how GLP-1 agonists work begins with grasping the role of the GLP-1 hormone itself. Glucagon-like peptide-1 (GLP-1) is a hormone released by gut cells after a meal, playing a pivotal role in managing blood glucose and overall metabolism.

Here’s how natural GLP-1 works:

Stimulating insulin release: The hormone enhances insulin secretion from pancreatic β-cells, but only when blood sugar levels are high—a clever mechanism that helps maintain glucose balance without causing hypoglycemia.
Inhibiting glucagon secretion: Simultaneously, GLP-1 signals your pancreas to reduce the production of glucagon, a hormone that raises blood sugar, from pancreatic α-cells, curbing excessive glucose production by the liver.
Slowing gastric emptying: GLP-1 slows down the rate at which food leaves your stomach and enters the small intestine. This contributes to a feeling of fullness that lasts longer and also leads to a more gradual rise in blood sugar after eating.
Increasing satiety and reducing appetite: GLP-1 acts on the brain to decrease hunger signals and increase feelings of satiety, which can lead to reduced food intake and potential weight loss.

When taking GLP-1 agonists, they mimic the natural actions of the GLP-1 hormone, but often with a longer-lasting effect. By binding to and activating the same GLP-1 receptors in your body, these medications can effectively enhance insulin secretion when needed, suppress glucagon, slow digestion, and promote satiety, ultimately aiding in blood sugar control and weight management.

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Knowing how these medications function is one thing, but figuring out when to take them is the next step in mastering your health plan.

When to take a GLP-1 agonist?

GLP-1 agonists have become valuable tools in managing specific health conditions. So, it is crucial to understand when and how they are prescribed. Doctors often consider introducing GLP-1 agonists for the following conditions:

Type 2 diabetes

GLP-1 agonists play a significant role in improving blood sugar control in adults diagnosed with type 2 diabetes. They are often used as part of a comprehensive treatment plan that includes lifestyle modifications like diet and exercise.

While there are various other types of diabetes medications available, including oral medications like metformin (often the first-line treatment for T2D), your healthcare provider might recommend a GLP-1 agonist in the following situations:

Metformin is not effectively managing your T2D: If your blood sugar levels remain high despite metformin treatment.
Metformin is unsafe for you (contraindication): If you have a medical condition that prevents you from taking metformin.
Your A1C is higher than your target. The A1C test provides an average of your blood sugar levels over the past 2-3 months.
You haven't reached your target A1C within three months of treatment, and you have additional conditions such as atherosclerosis (plaque buildup in arteries), heart failure, or chronic kidney disease. In these cases, GLP-1 agonists may offer additional benefits beyond blood sugar control.

Obesity

GLP-1 agonists can be prescribed to adults who are classified as obese or overweight. Obesity is recognised as a chronic medical condition characterised by having a body mass index (BMI) of 30 or higher.

Healthcare providers may also prescribe GLP-1 agonists for overweight individuals (with a BMI between 25 and 29.9) who have other health conditions. Losing weight could provide significant health benefits in managing these coexisting conditions.

It's important to understand that obesity is a complex condition, and effective management often involves a multi-faceted approach, which can include:

Dietary changes
Regular exercise
Medications (including GLP-1 agonists for some individuals)
Behaviour modification programs
In some cases, bariatric (weight loss) surgery

So, can you pop a pill or inject yourself with these medications daily? Let’s understand the ideal frequency for taking them!

How often should you take a GLP-1 agonist?

The frequency with which GLP-1 agonists are administered can vary significantly depending on the specific medication prescribed. Some are designed for daily use, while others are administered once a week.

These medications also come in different formulations:

Injections: Many GLP-1 agonists are given as subcutaneous (under the skin) injections. These are often available in pre-filled pens for ease of use. The injection site (abdomen, thigh, or upper arm) and the timing of the injection (with or without meals, time of day) can vary based on the specific drug.
Oral: Notably, some GLP-1 agonists are now available in tablet form, offering a non-injectable option for some patients. These oral formulations may have specific instructions regarding when to take them in relation to food and other medications.

Here’s a general breakdown of the frequency:

Dulaglutide: Once a week.
Exenatide: Twice a day.
Exenatide extended-release: Once a week.
Liraglutide: Once a day.
Lixisenatide: Once a day.
Semaglutide: Once a week (for injectable forms) or once a day (for oral).
Tirzepatide (Mounjaro): Once a week.

Always follow your healthcare provider's instructions for the prescribed GLP-1 agonist, as dosage and administration can vary based on individual needs and the specific medication.

Next, let’s explore the broader benefits of GLP-1 agonists and why they’re making waves in the medical field.

Benefits of GLP-1 agonists

GLP-1 agonists are grabbing attention for their benefits beyond managing blood sugar and weight. These medications hold potential for improving several aspects of health, making them a versatile tool in the therapeutic arsenal:

Lowering blood pressure: Some GLP-1 agonists have been observed to have a modest blood pressure-lowering effect, which can be beneficial for overall cardiovascular health.
Improving lipid disorders: These medications may help improve cholesterol and triglyceride levels, contributing to a healthier lipid profile.
Improving fatty liver disease: GLP-1 agonists can help reduce fat accumulation in the liver, potentially improving non-alcoholic fatty liver disease.
Reducing the risk of heart and kidney disease: Certain GLP-1 agonists have demonstrated a significant reduction in the risk of major cardiovascular events like heart attack and stroke, as well as improved kidney outcomes in individuals with type 2 diabetes and existing heart or kidney disease.
Delaying the progression of diabetes-related nephropathy (kidney damage): GLP-1 agonists may help slow down the progression of kidney damage associated with diabetes by improving blood sugar control and potentially having direct effects on the kidneys.

While these additional benefits are encouraging, it's crucial to discuss your health profile with your doctor to understand the potential benefits you might experience with a GLP-1 agonist.

Next, let's see what you really need to keep an eye on—the common side effects of GLP-1 agonists.

Common side effects of GLP-1 agonists

Like any medication, GLP-1 agonists can sometimes come with side effects. It's important to be aware of these potential effects, although they are manageable and often lessen over time as the body adjusts to the medication. These side effects are also more likely to occur when you first start taking a GLP-1 agonist or when your dose is increased.

The most common side effects associated with GLP-1 agonists include the following:

Nausea
Vomiting
Diarrhoea
Constipation
Bloating
Stomach pain

Other, less frequent side effects that some individuals may experience are:

Dizziness
Mild tachycardia (an increased heart rate)
Heartburn
Infections, such as upper respiratory tract infections
Headaches
Indigestion (upset stomach)
Temporary mild itchiness and/or redness on your skin at the site of the injections (for injectable forms)
Changes in facial appearance, such as sagging or wrinkles
Fatigue or tiredness
Anxiety
Depression
Hair loss or thinning
Loss of appetite and the resultant weight loss

While less common, some potentially serious side effects can occur, although they are considered rare:

Pancreatitis (inflammation of the pancreas): GLP-1 agonists may increase the risk of the pancreas becoming inflamed. Symptoms can include severe abdominal pain, nausea, and vomiting. Seek immediate medical attention if these occur.
Gallbladder issues: These medications might increase the risk of developing gallbladder problems, such as gallstones. Symptoms can include sudden pain in the upper right abdomen, pain in the back, nausea, and vomiting.
Potential increased risk of medullary thyroid cancer (a rare type of thyroid cancer): Animal studies suggest a possible increased risk of this rare thyroid cancer. Doctors usually avoid these drugs in individuals with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2.
Acute (sudden) kidney injury: Severe and persistent gastrointestinal side effects (nausea, vomiting, diarrhoea) can lead to dehydration, potentially causing a sudden decline in kidney function. Staying hydrated is important.
Worsening of diabetes-related retinopathy (damage to the blood vessels in the retina of the eye): In individuals with existing diabetic eye disease, GLP-1 agonists might temporarily worsen this condition, especially with rapid blood sugar improvement. Close monitoring by your doctor is necessary.

It's crucial to discuss these potential side effects with your doctor before starting a GLP-1 agonist so you know what to watch out for and how to manage any discomfort.

Ready to get the scoop on the more serious risks associated with GLP-1 agonists? Let's keep going!

Risks of GLP-1 agonists

While GLP-1 agonists offer significant benefits for many, it's also important to be aware of the potential risks associated with their use. These risks, though sometimes less common than the general side effects, warrant careful consideration and discussion with your healthcare provider.

Here are some potential risks associated with GLP-1 agonist use:

Allergic reactions: Although rare, serious allergic reactions to GLP-1 agonists can occur. Signs and symptoms may include rash, hives, swelling of the face, lips, tongue, or throat, and difficulty breathing or swallowing. It's crucial to seek immediate medical attention if you experience any of these symptoms.
Use during pregnancy and breastfeeding: The safety of GLP-1 agonists during pregnancy and breastfeeding has not been fully established. These medications may pose risks to the developing foetus. Therefore, it's vital to have a thorough discussion with your doctor if you are pregnant, planning to become pregnant, or breastfeeding before starting or continuing a GLP-1 agonist.
Low blood sugar (Hypoglycemia): GLP-1 agonists have a relatively low risk of causing low blood sugar when used alone. However, the risk of hypoglycemia can increase significantly when GLP-1 agonists are used in combination with other medications that lower blood sugar, such as insulin or sulfonylureas.

Symptoms can include dizziness, sweating, confusion, and tremors. Your doctor will need to carefully adjust the dosages of your medications to minimise this risk and educate you on the signs and symptoms of low blood sugar.

Consult your doctor immediately if you experience any severe symptoms or have concerns about potential risks while taking a GLP-1 agonist. They can assess your situation, determine if the symptoms are related to the medication, and provide appropriate guidance.

GLP-1 agonists stand as powerful medications for managing type 2 diabetes and obesity. However, you must be well-informed about the potential side effects and risks associated with their use. By openly discussing the potential benefits alongside the possible risks with your doctor, you can make an informed decision that aligns with your health needs and goals.

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