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Abstract
Obesity and type 2 diabetes mellitus (T2DM) are the main metabolic diseases in the world, and they are closely related in pathogenesis. Obesity can induce insulin resistance and chronic inflammation, while T2DM is often accompanied by abnormal distribution of body fat, which further aggravates metabolic disorder. Traditional treatment methods have some problems, such as hypoglycemia risk, weight gain and limited long-term curative effect. Therefore, the development of new hypoglycemic and weight-reducing drugs has become a clinical demand. GLP-1 receptor agonists (GLP-1 RAs), as a new generation of hypoglycemic drugs, has become a breakthrough in the treatment of obesity complicated with T2DM with its unique glucose-dependent hypoglycemic mechanism, significant weight loss effect and potential cardiovascular protection. By activating GLP-1 receptors, GLP-1 RAs enhance insulin secretion, suppress glucagon release, delay gastric emptying, and inhibit appetite, thereby improving glycemic control and reducing energy intake. Multiple clinical trials have confirmed that GLP-1 RAs can significantly lower glycated hemoglobin (HbA1c) levels, reduce body weight by 5%-15%, and decrease the risk of cardiovascular events by 13%-26%. However, their mechanism of action has not been fully elucidated, and differences in efficacy and long-term safety still require further investigation. This article reviews the current application of GLP-1 RAs in the treatment of obesity combined with T2DM, explores their multi-faceted mechanisms of action in glycemic control, weight loss, and cardiovascular protection, and analyzes their efficacy and safety based on the latest clinical research data to provide a reference for rational clinical use.
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