GLP-1 RECEPTOR AGONISTS IN TYPE 2 DIABETES MELLITUS: CLINICAL IMPLICATIONS BEYOND GLYCEMIC CONTROL

• DOI: https://doi.org/10.22533/at.ed.5157272624031

• Palavras-chave: GLP-1; Type 2 Diabetes Mellitus; Cardiovascular Outcomes; Renal Protection.

• Keywords: GLP-1; Type 2 Diabetes Mellitus; Cardiovascular Outcomes; Renal Protection.

• Abstract:

  The use of glucagon-like peptide-1 receptor agonists in type 2 diabetes mellitus has been widely discussed in the contemporary literature, especially given the need for therapeutic strategies that go beyond isolated glycemic control. This study aimed to review the scientific evidence regarding the clinical effects of this pharmacological class, addressing its mechanisms of action, metabolic impact, and cardiovascular and renal outcomes. A search was conducted in the PubMed, Scielo, Medline, and UpToDate databases, including publications from 2022 to 2026, using the search terms “GLP-1,” “type 2 diabetes mellitus,” “cardiovascular outcomes,” and “renal protection.” From the initial selection of studies, articles were included that comprised clinical trials, systematic reviews, and meta-analyses relevant to the topic. The analyzed data demonstrated that GLP-1 receptor agonists promote a significant reduction in glycated hemoglobin, a low risk of hypoglycemia, and consistent weight loss, in addition to robust evidence of a reduction in major cardiovascular events and a slowing of the progression of chronic kidney disease. However, limitations related to gastrointestinal adverse events, high cost, and global access disparities stand out; these factors may impact adherence and widespread implementation in clinical practice. It is concluded that GLP-1 receptor agonists are established as outcome-modifying therapies in type 2 diabetes mellitus, with integrated cardiometabolic benefits, although their definitive incorporation depends on strategies that balance clinical efficacy, safety, cost-effectiveness, and equity in access.