2025-2026 GLP-1 RA Updates:
- Liraglutide:
- Dose: 3.0 mg QD (6% A1c reduction), 1.8 mg QD (4.7% A1c reduction)
- Side effects: Gastrointestinal (nausea, vomiting, diarrhea, reflux), hypoglycemia (with insulin/sulfonylurea), contraindicated in MTC/MEN2
- Tirzepatide (Dual GIP/GLP-1 RA):
- Dose: 15 mg weekly (14.7% A1c reduction), 10 mg weekly (12.8% A1c reduction)
- Side effects: Nausea (11–40%), vomiting (4–13%), diarrhea (9–17%)
- Rationale: Dual agonism enhances glucose control; GI side effects remain primary concern.
- Depression Considerations:
- GLP-1 RAs may have neuroprotective effects, but depression is not a formal indication.
- Rationale: Limited evidence; monitor for mood changes in elderly patients.