Derivatives of the intestal hormone GLP-1 are efficient medicines used to treat blood sugar in type 2 diabetes. Often, they also cause clear weight loss.
GLP-1 products are used to treat type 2 diabetes in adults as a phase two or three pharmaceutical product in combination with other diabetes medicines or basal insulin. They can also be used alone, if it not possible to use other diabetes medication due to side effects or contraindications.
In Finland, KELA offers limited reimbursement (7/2023) for four GLP-1 products: dulaglutide, exenatide, liraglutide and semaglutide. GLP-1 derivatives are injection products. Semaglutide also comes as a tablet.
Liraglutide can also be used to treat type 2 diabetes in a child or young person aged 10 or over. There is also a separate liraglutide product available for the treatment of severe obesity.
GLP-1 (glucagon-like peptide 1) is a hormone that is secreted from the small intestine at mealtimes. It increases the secretion of blood sugar-lowering insulin from pancreatic beta cells, reduce the secretion of blood sugar-increasing glucagon from pancreatic alpha cells and reduce the rate at which the stomach empties, increasing the feeling of fullness.
GLP-1 products are modified products similar to body’s own GLP-1 hormone, which lower the blood sugar level and promote weight loss.
Some GLP-1 prodcuts have been shown to have a protective effect against cardiovascular events.
GLP-1 products are injected subcutaneously. Semaglutide can also be taken as a tablet.
The dose is titrated within a few weeks or months. For some of the products, the dose is taken once or twice a day, for others, it is taken once a week. A nurse will teach you the correct use of each product. At the same time they will teach the correct injection technique and dosing.
In normal use, GLP-1 products do not cause your blood sugar to drop too low. After starting the medication, quantity of food should not be increased. Instead, quantity should be reduced the quantity if there is overweight. The product doses do not need to be adjusted according to alternating eating habits or exercise. When the product is used together with insulin, the need for insulin is normally reduced. For some people, the insulin injection can be replaced with a GLP-1 injection. The insulin dose is reduced on the basis of self-measurements and the doctor’s instructions.
GLP-1 products are not used while pregnant or breastfeeding.
As GLP-1 products decrease the rate at which stomach empties, they are not usually suitable if a person has a stomach disorder or intestinal disorders. Depending on the product, kidney failure, hepatic insufficiency or severe heart failure may limit the use of the products.
KELA offers reimbursement for the use of GLP-1 products to a limited extent. At the moment (7/2023), the remuneration is granted on the basis of a doctor’s B referral, if the treatment target for blood sugar has not been reached by using other treatments in accordance with the treatment guidelines and the patient’s BMI is 30 kg/m2 or higher.
Normally, there is a good tolerance for GLP-1 products. Some stomach issues or nausea may occur at the early stages of the treatment. The does should be increased according to the tolerance.
A rare verified side effect of GLP-1 products is an acute pancreatitis. A typical symptom of pancreatitis is severe pain in the upper part of the stomach, which radiates to the back.
