Medicines first developed to treat type 2 diabetes are proving to have benefits far beyond controlling blood sugar.
A major new study has found that a group of drugs called GLP-1 receptor agonists can help protect both the heart and the kidneys. Even more surprising, these benefits were seen not only in people with diabetes but also in people without the disease.
The research was published in The Lancet Diabetes & Endocrinology and is the largest and most detailed review ever carried out on these medicines. The findings suggest that GLP-1 receptor agonists could play an important role in preventing some of the world’s biggest health problems, including heart disease and chronic kidney disease.
GLP-1 receptor agonists work by copying the action of a natural hormone in the body called glucagon-like peptide-1.
This hormone helps the body release insulin after meals, lowers blood sugar, slows the movement of food through the stomach, reduces hunger, and helps people feel full for longer. Because of these effects, many people also lose weight while taking these medicines.
Some of the best-known GLP-1 medicines include semaglutide, sold under brand names such as Ozempic and Wegovy, dulaglutide, sold as Trulicity, and liraglutide, sold as Victoza. They have become increasingly popular in recent years because they can help people manage diabetes and obesity.
Doctors already knew that these medicines reduced the risk of heart attacks and strokes in many patients with diabetes. However, it was less clear whether they could also protect the kidneys. The new study provides strong evidence that they can.
Researchers combined results from 11 large clinical trials involving more than 85,000 participants. Nearly 68,000 had type 2 diabetes, while the remaining participants had obesity or heart disease but did not have diabetes. The studies included seven different GLP-1 receptor agonist medicines.
The results were impressive. Compared with people taking a placebo, those receiving GLP-1 receptor agonists had a 16% lower risk of developing kidney failure. Their risk of worsening kidney function was reduced by 22%.
When researchers combined several kidney-related outcomes, including kidney failure, declining kidney function, and death caused by kidney disease, the overall risk was 19% lower.
The medicines also continued to show strong protection for the heart. People taking GLP-1 receptor agonists had a 14% lower risk of dying from heart disease, suffering a non-fatal heart attack, or having a stroke. In addition, their overall risk of dying from any cause was 13% lower than people taking a placebo.
Lead researcher Professor Sunil Badve from The George Institute for Global Health and UNSW Sydney said the findings are important because they show these medicines provide benefits that go well beyond blood sugar control. They appear to protect important organs even in people who do not have diabetes.
This is especially important for people living with chronic kidney disease, often called CKD. CKD is a long-term condition in which the kidneys gradually lose their ability to filter waste from the blood. As the disease progresses, some people eventually need dialysis or a kidney transplant. People with CKD are also much more likely to develop serious heart disease.
Chronic kidney disease is a growing global health problem. Around 850 million people worldwide are estimated to have the condition, affecting about one in every ten people. It is already one of the leading causes of death and experts predict it could become the fifth leading cause by 2050. Diabetes, obesity, and heart disease are among the biggest risk factors.
Senior author Professor Vlado Perkovic said the study shows that GLP-1 receptor agonists could become an important tool for preventing and treating several major chronic diseases at the same time. He hopes the findings will influence future medical guidelines and improve access to these medicines for people who could benefit from them.
The researchers say the next challenge is to bring these discoveries into everyday medical care. More patients may soon benefit from treatments that not only control diabetes and support weight loss, but also help protect the heart and kidneys, reduce the risk of serious illness, and improve long-term health.
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