Glycemic Outcomes of Oral Hypoglycemics Versus GLP-1 Receptor Agonists in Type 2 Diabetes: A Comparative Clinical Study
Oral Hypoglycemics Versus GLP-1 Agonists in Type 2 Diabetes Glycemic Control
DOI:
https://doi.org/10.69750/dmls.02.010.0168Keywords:
Diabetes, Glycemia, GLP-1, Hypoglycemia, Obesity, Treatment, Incretins, Insulin, MetabolismAbstract
Background: Type 2 Diabetes Mellitus (T2DM) is one of the most significant health concerns around the world, especially in South Asian communities, where the escalating burden of obesity and sedentary lifestyles has intensified the disease. Although oral hypoglycemic agents (OHAs) remain first-line treatment, glucagon-like peptide-1 (GLP-1) receptor agonists have become an effective alternative since they have a glucose-dependent insulinotropic effect, reduce weight, and have fewer adverse effects, particularly hypoglycemia. There is limited comparison of clinical evidence of local settings, however.
Objectives: To evaluate the efficacy of OHAs and GLP-1 receptor agonists in enhancing glycemic regulation in adults with T2DM.
Methods: A comparative clinical study was carried out in Shaikh Zayed Hospital, Lahore, between January 2024 and March 2025. Eighty adult participants with T2DM were recruited through consecutive sampling and separated into 2 equal groups: Group A was provided with regular OHAs and Group B was prescribed GLP-1 receptor agonists. Fasting blood sugar (FBS), random blood sugar (RBS), and HbA1c were measured at baseline and 6 months. Statistical software SPSS 26 version was utilized and p less than 0.05 was regarded to be significant.
Findings: Both groups experienced an improvement in glycemic parameters and the GLP-1 group had significantly more decreases in the HbA1c (1.8 vs. 1.0), FBS and RBS (p < 0.01). Also, the GLP-1 group obtained significant losses (3.4 kg) in weight, but the OHA did not. Hypoglycemia was more prevalent among users of OHA whereas gastrointestinal symptoms were a little bit more prevalent among users of GLP-1.
Conclusion: GLP-1 receptor agonists offer a benefit in glycemic control and weight loss over traditional OHAs and reduced hypoglycemic events. These agents are a good therapeutic alternative in the management of T2DM, particularly when the patient needs a better metabolism.
Downloads
References
Cornell S, Saum K. A review of GLP-1 receptor agonists in type 2 diabetes. Int J Clin Pract. 2020;74(12):e13695. doi:10.1111/ijcp.13695.
Ansari HUH, Al-Jubairi A, Hassan S, et al. Efficacy and safety of glucagon-like peptide-1 receptor agonists in adults with overweight or obesity: a meta-analysis. Diabetes Ther. 2024;15(3):357-376. doi:10.1007/s13300-024-01220-0.
Alfaris N, Hassan A, Al-Nasser Y, et al. GLP-1 single, dual, and triple receptor agonists for the treatment of type 2 diabetes and obesity: current evidence and future perspectives. eClinicalMedicine. 2024;58:101938. doi:10.1016/j.eclinm.2023.101938.
Collins L, Thomas K. Glucagon-Like Peptide-1 Agonists. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
Yao H, Wu T, Zhang S, et al. Comparative effectiveness of GLP-1 receptor agonists on glycemic control and weight management in type 2 diabetes: a network meta-analysis. BMJ. 2024;384:e076410. doi:10.1136/bmj-2023-076410.
Caruso I, Di Gioia L, Di Molfetta S, et al. Glucometabolic outcomes of GLP-1 receptor agonist-based therapies in patients with type 2 diabetes: a systematic review and network meta-analysis. eClinicalMedicine. 2023;64:102181. doi:10.1016/j.eclinm.2023.102181.
Xie Z, Liang H, Zhang D, et al. Comparison of efficacy and safety of ten GLP-1 receptor agonists in type 2 diabetes: systematic review and network meta-analysis. Diabetes Obes Metab. 2023;25(7):1890-1903. doi:10.1111/dom.15189.
Zheng Z, Li Y, Wang Y, et al. Glucagon-like peptide-1 receptor: mechanisms and therapeutic implications in metabolic disease. Signal Transduct Target Ther. 2024;9:387. doi:10.1038/s41392-024-01931-z.
He X, Gao S, Li J, et al. Research progress of GLP-1 receptor agonists in the treatment of type 2 diabetes: a comprehensive review. Front Pharmacol. 2025;15:1483792. doi:10.3389/fphar.2024.1483792.
Moiz A, Rahman S, Baig M, et al. The expanding role of GLP-1 receptor agonists beyond glycemic control: impact on steatosis, inflammation, and metabolic health. Pharmacol Ther. 2025;247:108782. doi:10.1016/j.pharmthera.2024.108782.
Osumili B, Lim JT, Sun H, et al. Efficacy and safety of tirzepatide compared with GLP-1 receptor agonists and placebo in type 2 diabetes patients on basal insulin: a network meta-analysis. Diabetes Metab Res Rev. 2025;41(2):e3561. doi:10.1002/dmrr.3561.
Alkhezi OS, Al-Mutairi A, Al-Shammari N, et al. A network meta-analysis of randomized clinical trials comparing GLP-1 receptor agonists for weight loss in type 2 diabetes. Obes Rev. 2023;24(9):e13627. doi:10.1111/obr.13627.
Karagiannis T, Avgerinos I, Liakos A, et al. Head-to-head comparison of tirzepatide vs semaglutide in type 2 diabetes and obesity: a systematic review and network meta-analysis. Diabetologia. 2024;67(10):2250-2262. doi:10.1007/s00125-024-06144-1.
Jiang Y, Chen S, Li L, et al. Real-world effectiveness and safety of GLP-1 receptor agonists in type 2 diabetes: a retrospective cohort study. Front Endocrinol. 2024;15:1347684. doi:10.3389/fendo.2024.1347684.
Krisanapan P, Pattanasedtee W, Pin-On P, et al. Safety and efficacy of GLP-1 receptor agonists in type 2 diabetes patients with advanced chronic kidney disease: systematic review and meta-analysis. Medicina. 2024;60(1):14. doi:10.3390/medicina60010014.
Taktaz F, Huang K, Patel M, et al. Bridging the gap between GLP-1 receptor agonists and novel dual agonists for type 2 diabetes: therapeutic advancements. Cardiovasc Diabetol. 2024;23(1):219. doi:10.1186/s12933-024-02319-7.
Chen X, Zhao Y, Xu H, et al. Effects of GLP-1 receptor agonists on cardiovascular and renal outcomes in high-risk type 2 diabetes patients: systematic review and meta-analysis. Diabetol Metab Syndr. 2024;16:122. doi:10.1186/s13098-024-01497-4.
Wang W, Li Y, Zhang S, et al. Effects of GLP-1 receptor agonists on glucose metabolism, blood pressure, and body weight in overweight/obese prediabetes: a meta-analysis. Diabetes Obes Metab. 2023;25(5):1243-1253. doi:10.1111/dom.15092.
Son JW, Kim S, Lee MK. Novel GLP-1-based medications for type 2 diabetes and obesity: mechanism, development, and future directions. Endocr Rev. 2025;46(1):bnaf036. doi:10.1210/endrev/bnaf036.
Yepes-Cortés CA, Saavedra J, Vásquez A, et al. Combining GLP-1 receptor agonists and SGLT-2 inhibitors in type 2 diabetes: clinical evidence and practical considerations. Diabetes Ther. 2025;16(2):813-829. doi:10.1007/s13300-025-01722-x.
Caruso I, Rossi A, Di Gioia L, et al. Real-world safety profile of tirzepatide: systematic review and meta-analysis of randomized trials. J Endocrinol Invest. 2024;47(8):1595-1607. doi:10.1007/s40618-024-02441-z.
Tschöp M, Müller TD, Finan B, et al. Future perspectives in incretin-based therapy for metabolic disease: GLP-1/GIP co-agonists and beyond. Nat Rev Endocrinol. 2024;20(11):777-792. doi:10.1038/s41574-024-00824-5.
Collins L, O’Neal KS. GLP-1 receptor agonists: updated guidance for clinical practice in type 2 diabetes management. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
Hu EH, Li X, Yang H, et al. Safety and efficacy of GLP-1 receptor agonists in type 2 diabetes patients with cardiovascular disease: a meta-analysis. Healthcare. 2024;12(3):357. doi:10.3390/healthcare12030357
Downloads
PlumX Metrics
Published
Issue
Section
How to Cite
