Hormonal
GLP-1 receptor agonists (GLP-1RA) provide superior glycemic control and weight loss compared to DPP-4 inhibitors in patients with type 2 diabetes, despite a higher incidence of gastrointestinal side effects.
If you have Type 2 Diabetes and are struggling with blood sugar and weight despite taking metformin, switching from a DPP-4 inhibitor (like sitagliptin) to a GLP-1 receptor agonist (like semaglutide or liraglutide) is likely to give you better blood sugar control and more weight loss. Be prepared for some initial stomach upset (nausea), which usually gets better over time. If you strongly dislike injections, ask about oral semaglutide, which offers similar benefits without needles.
These studies have generally demonstrated that the GLP-1 RA provided superior glycemic control and weight loss relative to the DPP-4 inhibitor. Both treatments were associated with a low and comparable incidence of hypoglycemia, but treatment with GLP-1 RAs were invariably associated with a higher incidence of GI adverse events.
Why this rating
Based on a review of multiple head-to-head randomized controlled trials and meta-analyses.
Source
GLP-1 Analogs and DPP-4 Inhibitors in Type 2 Diabetes Therapy: Review of Head-to-Head Clinical Trials
Matthew P. Gilbert et al. · Frontiers in Endocrinology · 2020
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