The Role of GLP-1 Receptor Agonists (e.g., Ozempic) in Decreasing Disparities in Diabetes and Obesity Care: A Systematic Review of Efficacy, Access, and Public Health Equity Implications

Introduction

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide (Ozempic), have revolutionized the management of type 2 diabetes and obesity, with benefits beyond glycemic control, including weight loss and cardiovascular protection. Access to these drugs, despite their efficacy, is unequal, with marginalized populations facing considerable barriers in the way of cost, lack of insurance, and geographic disparities. This systematic review seeks to evaluate the efficacy, safety, and equity implications of using GLP-1 RAs in treating diabetes and obesity and propose means by which access can be enhanced.

Methods

Systematic searching was carried out in Embase, PubMed, Cochrane Library, and clinical trial registers using the terms “GLP-1 receptor agonists,” “semaglutide,” “diabetes,” “obesity,” “health disparities,” and “access.” Only randomized controlled trials (RCTs), observation studies, and systematic reviews from the last seven years (2018-2024) were included. Data extraction followed PRISMA guidelines, and the risk of bias was assessed with the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Meta- analyses were performed to pool data on weight loss and glycemic control.

Results

The result shows that of 1,235 records identified, 45 studies met the inclusion criteria. Semaglutide demonstrated better effect, such as average HbA1c reduction -1.5% (95% KI: -1.7 to -1.3) and 12.4% (95% CI: 11.8 to 13.0), with other GLP -1 RAS and traditional treatments better than conventional treatments. Reduction in cardiovascular risk was significant, with a 26% reduction in larger side effects in cardiovascular events (HR: 0.74; 95% CI: 0.68 to 0.81). Safety profiles were favorable; gastrointestinal side effects were the most common but generally mild. However, access inequalities were evident: black and Latin American patients had 40% less probability of getting GLP -1 RAS and were 50% smaller manufacturers in rural areas. Innovative strategies such as telehealth models and policy intervention promised to improve access, with an increase of 30% in telecommunications tips.

Conclusion

GLP-1 RAS, especially Semaglutide, is very effective and safe for handling diabetes and overweight. However, there are still many inequalities in access, which affect individuals in racial/ethnic minorities, poor and rural communities. The disruption of these barriers by telehealth, policy reform, and community-based services is paramount for health equity. The focus of this review is that equal access to GLP-1 RAs is a national public health priority. Insurance expansion, drug cost decreases, and expansion of telehealth and community-based services are paramount steps in closing gaps and improving outcomes in individuals with diabetes and obesity. A national public health priority must be equal access to GLP-1 RAs to improve outcomes and close gaps in individuals with diabetes and obesity.