Type 2 diabetes (T2D) is a progressive metabolic disorder characterized by insulin resistance, beta-cell dysfunction, and chronic hyperglycaemia with significant risk of renal and / or cardiovascular complications. Given the close relationship between T2D and obesity, weight reduction has long been recognized as a key goal for patients with T2D. Although weight loss of 10-15% is associated with improved insulin sensitivity and glycaemic control, traditional approaches to weight management (i.e. diet and exercise) typically do not achieve durable weight reduction. Indeed, only 1 in 5 individuals with overweight or obesity are successful in sustaining >10% weight loss long-term with lifestyle interventions alone. Importantly, weight regain is paralleled by declines in glycaemic control and T2D progression.
In the past two decades, the development of the glucagon-like peptide-1 (GLP-1) receptor agonists has reshaped the therapeutic landscape of chronic weight management and cardiometabolic diseases, including T2D. These drugs elicit greater weight loss than is achieved by lifestyle intervention alone and lead to wide-ranging cardiometabolic benefits. In this article, we discuss what the rapid evolution of these drugs means for patients with T2D.
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