Metabolic effects of glucagon-like peptide-1 receptor agonists The arGLP-1 s show a potent antihyperglycemic effect with decreases between 0.5% and 1.3% of HbA1c, which is greater in those with a long half-life56 with low risk of hypoglycemia, as has been shown in cardiovascular safety studies, where there were no differences in hypoglycemia rates versus placebo, except if associated with sulfonylureas or insulin.5764 The low risk of hypoglycemia has been observed even in patients with DKD.6567 who are more susceptible to this complication.16 It is also important to highlight the loss of weight and waist circumference with arGLP-1, mainly as a consequence of a reduction in body fat and not in lean mass, which is maintained during long-term follow-up.68 This weight loss is attributed to the slowing of gastric emptying which increases satiety, to the increase in resting energy consumption and its direct effects on appetite and satiety control centers in the CNS
In addition, it is recommended that the duration of future clinical trials of GLP-1RAs for AD extend to 2 to 3 years to evaluate long-term outcomes, including changes in cognition, activities of daily living, instrumental activities of daily living, and biomarkers for tau and A
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