Glucagon-Like Peptide-1 Receptor Agonists: Their Potential Role in Prediabetes.

IF 2.6 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2026-05-01 Epub Date: 2026-04-15 DOI:10.1007/s13300-026-01865-5

Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Dimitrios Papazoglou, Nikolaos Papanas

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Abstract

Prediabetes is a frequently occurring condition with increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established antidiabetic agents, also used to treat obesity. There is limited, yet promising evidence on their use in prediabetes. T2DM was less frequent among subjects on liraglutide, semaglutide and tirzepatide compared with the control arm. Delayed progression to T2DM has also been observed. Furthermore, normoglycaemia was achieved for subjects on liraglutide (up to 66%), semaglutide (up to 81%) and tirzepatide (up to 93.3%). However, this effect was only partially sustained following drug withdrawal. GLP-1RAs have led to modest decreases in glycated haemoglobin (HbA_1c), fasting glucose, weight and fat mass loss, as well as increased insulin sensitivity and improved β-cell glucose-insulin dynamics. Decreased risk for atherosclerotic cardiovascular disease and heart failure was also demonstrated, mostly for subjects on tirzepatide. There is experimental evidence on improvements in liver dysfunction, pointing to potential benefits for metabolic dysfunction-associated steatotic liver disease (MASLD) in prediabetes. The safety profile was acceptable with mild-to-moderate gastrointestinal adverse effects being mostly reported. Future large randomised controlled trials are needed to ascertain the exact role of GLP-1RAs in prediabetes.

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胰高血糖素样肽-1受体激动剂：它们在糖尿病前期的潜在作用。

糖尿病前期是一种常见病，伴有2型糖尿病（T2DM）和心血管疾病的风险增加。胰高血糖素样肽-1受体激动剂（GLP-1RAs）是公认的抗糖尿病药物，也用于治疗肥胖。关于它们在前驱糖尿病中的应用，证据有限，但很有希望。与对照组相比，利拉鲁肽、西马鲁肽和替西帕肽组的T2DM发生率较低。T2DM的延迟进展也被观察到。此外，利拉鲁肽（高达66%）、西马鲁肽（高达81%）和替西帕肽（高达93.3%）的受试者达到了正常血糖。然而，这种效果在停药后仅部分持续。GLP-1RAs导致糖化血红蛋白（HbA1c）、空腹血糖、体重和脂肪量的适度降低，以及胰岛素敏感性的增加和β细胞葡萄糖-胰岛素动力学的改善。动脉粥样硬化性心血管疾病和心力衰竭的风险降低也被证实，主要是替西肽的受试者。有实验证据表明，改善肝功能障碍对糖尿病前期代谢功能障碍相关的脂肪变性肝病（MASLD）有潜在的益处。安全性是可以接受的，轻微到中度的胃肠道不良反应大多被报道。未来需要大型随机对照试验来确定GLP-1RAs在前驱糖尿病中的确切作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.