Introduction: GLP-1 receptor agonists (GLP-1RAs) are drugs used in the treatment of type 2 diabetes and obesity, and are believed to have potential neuroprotective properties. Decreased glucose metabolism in the brain, the development of neuronal insulin resistance, and abnormal tau protein phosphorylation and amyloid-β deposition all play important roles in the pathogenesis of Alzheimer's disease (AD). Numerous preclinical studies in animal models have demonstrated that GLP-1 analogs, such as liraglutide and lixisenatide, are capable of crossing the blood-brain barrier, stimulating neurogenesis, limiting tau hyperphosphorylation, reducing amyloid-β deposition, and improving synaptic and cognitive functions. Data from clinical and observational studies suggest that GLP-1RA use in patients with type 2 diabetes is associated with a reduced risk of developing dementia, including AD. In large retrospective analyses, semaglutide therapy reduced the likelihood of a first diagnosis of Alzheimer's disease by 40–70% compared with other antidiabetic agents. In a randomized trial, liraglutide prevented the decline in brain glucose metabolism in patients with AD, but had no significant effect on amyloid-β levels or cognitive function. Review methods: A comprehensive analysis of research papers available on PubMed and Google Scholar was conducted using keywords: Alzheimer's disease, neurodegeneration, GLP-1 analogues, liraglutide, dementia, tau, diabetes, obesity Conclusion: Accumulating evidence suggests that GLP-1 agonists may be a promising therapeutic option for the prevention and treatment of neurodegenerative diseases. However, further randomized clinical trials are necessary to confirm their efficacy in patients with Alzheimer's disease. Keywords: Alzheimer's disease, neurodegeneration, GLP-1 analogues, liraglutide, dementia, tau, diabetes, obesity

Effect of glucagon-like peptide-1 agonists on deep inferior epigastric perforator flap breast reconstruction outcomes in obese patients: A study of 5618 patients.

Incretin-based therapies have become central to type 2 diabetes (T2D) management, offering benefits beyond glycemic control, including weight reduction, cardiovascular protection, and emerging roles in renal and neurological health. This review addresses the question: What are the recent advances in GLP-1, GIP, and glucagon receptor agonists, and how do formulation strategies overcome biopharmaceutical challenges? We systematically analyzed late-stage clinical trials and formulation approaches for peptide-based therapies. The review focuses on therapeutic efficacy, structural and physicochemical properties influencing absorption, distribution, and metabolic stability, and strategies to mitigate degradation pathways such as enzymatic hydrolysis and peptide aggregation. Additionally, innovative delivery systems such as oral peptide formulations and long-acting injectables demonstrate promise in addressing inherent challenges of peptide drug delivery. By integrating clinical outcomes with mechanistic and formulation insights, this review highlights the evolving landscape of incretin-based therapies and underscores innovative solutions for peptide stabilization and delivery. These findings provide a forward-looking perspective for clinicians, researchers, and pharmaceutical scientists engaged in T2D management and drug development.

GLP-1 Receptor Agonist Therapy Is Not Associated with Adverse Events Following Shoulder Surgery: A Systematic Review and Meta-Analysis.

The rising global prevalence of Type 2 Diabetes Mellitus (T2DM) and obesity has intensified the search for novel therapeutic agents, with Glucagon-like peptide-1 (GLP-1) emerging as a key regulator of glucose homeostasis and insulin secretion. While synthetic GLP-1 receptor agonists (RAs) like semaglutide and tirzepatide dominate clinical use, plant-derived GLP-1 modulators present a promising alternative due to their natural origin, diverse mechanisms, and potential for reduced side effects. This review systematically evaluates 34 medicinal plants—including Agave tequilana (fructans), Berberis vulgaris (berberine), Momordica charantia (bitter melon), and Panax ginseng (ginsenosides)—that exhibit GLP-1 agonist activity through pathways such as DPP-4 inhibition, bitter taste receptor activation, and SCFA-mediated GLP-1 secretion. Comparative analysis reveals that while synthetic agonists offer superior HbA1c reduction (1–2%) and weight loss (5–22.5%), natural compounds provide multimodal benefits, including anti-inflammatory, antioxidant, and beta-cell protective effects. However, clinical evidence remains limited, with most studies confined to preclinical models. Future research should prioritize human trials, bioavailability optimization, and synergistic formulations to harness the full therapeutic potential of plant-derived GLP-1 agonists in metabolic disorders.

Kaempferol‑copper complex alleviates oxidative stress and inflammatory response in acute alcoholic liver injury by inhibiting the TLR4/MAPK/NF-κB signaling pathway.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a commonly used class of antidiabetic medications in the treatment of type 2 diabetes mellitus and obesity management, and it is important to understand public awareness and attitudes toward GLP-1 RAs. This study aims to identify the level of awareness and knowledge about GLP-1 RAs in a heterogeneous population. This is an online survey study that was conducted in Saudi Arabia between December 2024 and January 2025 to examine community awareness and attitudes regarding the use of GLP-1 agonists as a treatment for obesity in Saudi Arabia. The questionnaire tool for this study was developed based on an extensive literature review. Multiple logistic regressions were performed to identify the predictors of knowledge about GLP-1 agonists. A total of 398 participants were included in the analysis. Regarding the GLP-1 enhancers, the majority (289, 72.6%) had heard of them before participating in the online survey. According to our participants, the most familiar one was mounjaro (262, 65.8%). Social media was the most common source (227, 57.0%). The majority reported using GLP-1 enhancers for weight reduction (319, 80.4%). Common side effects included loss of appetite (276, 69.3%), vomiting (196, 49.2%), and abdominal pain (188, 47.2%). The most frequently mentioned contraindications were pregnancy and lactation (295, 74.1%), pediatric age group (204, 51.3%), and kidney conditions (171, 43.0%). Individuals with an income between 5000 to 10,000 Saudi Arabian riyal (SAR) had significantly less knowledge of GLP-1 enhancers compared to those earning <5000 SAR (OR = 018, 95% CI: 0.03–0.99, P = .04). Additionally, individuals who had previously used or were currently using GLP-1 enhancers were significantly more likely to have better knowledge (OR = 6.56, 95% CI: 1.82–23.66, P = .004). Participants were moderately to highly aware of GLP-1 enhancers. Most people took these drugs to lose weight, with side effects including appetite loss, vomiting, and abdominal pain. Lactation, pregnancy, pediatric usage, and kidney problems were common contraindications. Lower-income groups knew more about GLP-1 enhancers than higher-income ones, and former or present users knew the most. Future studies should examine income-related knowledge gaps and social media’s educational potential. GLP-1 enhancers’ long-term safety, efficacy, and awareness across varied populations must be assessed in longitudinal research.

Diabetes is a long-term metabolic disorder characterized by elevated blood glucose levels and is primarily classified into Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM). Conventional drug delivery systems often face limitations such as low bioavailability, inadequate target specificity, and the need for frequent dosing. Drug targeting offers significant advantages in diabetes treatment by enhancing therapeutic efficacy and reducing side effects. This is achieved by binding drug-loaded carriers to specific receptors on insulin-sensitive tissues or pancreatic β-cells, ensuring precise action at the disease site and improving patient compliance. Several therapeutic targets have been identified to improve glycemic control and overcome the limitations associated with traditional drug delivery approaches. The present study provides insights into emerging targets for diabetes management, including AMPK (AMP-Activated Protein Kinase), glucose absorption inhibitors, renal glucose reabsorption inhibitors, GLP-1 (Glucagon- Like Peptide-1) agonists, SGLT2 (Sodium-Glucose Cotransporter-2) inhibitors, and PPAR-γ (Peroxisome Proliferator-Activated Receptor Gamma) modulators. Increasing attention is also being given to multi-targeted therapy, which simultaneously modulates multiple interconnected physiological pathways involved in diabetes pathogenesis. Such strategies have demonstrated the potential to improve glycemic control, reduce long-term complications, and offer better safety profiles compared to monotherapy. Given the multifactorial nature of diabetes, a combination of precisionbased and multi-targeted approaches holds promise for developing safer, better tolerated, and patient- centered antidiabetic therapies. This review highlights recent advances in identifying novel therapeutic targets and drug delivery strategies, contributing to the evolving paradigms that may shape the future of diabetes care.

Retrospective cohort study. This study aimed to examine outcomes in patients with adult spinal deformity (ASD) undergoing deformity correction with and without glucagon-like peptide-1 receptor agonist (GLP-1A) therapy. GLP-1As, widely used in diabetes management, have recently been linked to reduced postoperative complications. However, their role in spinal surgery remains underexplored. This multicenter, retrospective cohort study was conducted using the TriNetX Global Collaborative Database (2005-2025) utilizing Current Procedural Terminology and International Classification of Diseases, 10th Revision, codes for patients undergoing spinal deformity correction because of ASD. Patients prescribed GLP-1As within 1 year of surgery were 1:1 propensity-score matched with those who were not using GLP-1As. The cohort was matched according to patient demographics and comorbidities. Surgical outcomes between groups were analyzed at 1- and 2-year intervals. Significance was defined as p <0.05. At 1 and 2 years following surgery, patients taking GLP-1As exhibited significantly lower odds of pseudoarthrosis, hardware failures, wound dehiscence, infections, thromboembolic events, readmissions, and mortality. The findings reveal a significant reduction in the rates of pseudoarthrosis, hardware failure, readmission, and mortality in patients treated with GLP-1As. These results align with the recent literature, pointing to a potential complementary therapy in ASD management. Further studies characterizing the mechanism by which GLP-1As affect postoperative spinal physiology are warranted to assess their utility in optimizing patient outcomes.

Disparities in diabetes treatment and monitoring for people with and without mental disorders: a systematic review and meta-analysis.

Parkinsonism represents a spectrum of neuro-degenerative disorders hallmarked by progressive motor symptoms, with a growing recognition of diverse non-motor manifestations that significantly affects quality of life. The understanding of Parkinson’s disease is changing, with growing evidence showing that the gut-brain-axis is the communication link between the gut, brain, immune system, and gut microbes and plays an important role in how the disease starts and develops.This literature review systematically evaluates research published post-2020, focusing on mechanistic insights, clinical significance, and therapeutic possibilities of gut–brain axis modulation in parkinsonism. Database searches across PubMed and Google Scholar yielded 70 articles, with 29 English-language, full-text studies selected, emphasizing relevance to gut microbiota, intestinal barrier dysfunction, neuro-inflammatory mechanisms, and interventions targeting the GBA.Key findings highlight that early gastrointestinal dysfunction Precedes by many years before the classical motor symptoms appear in Parkinsonism. Accumulation of misfolded alpha-synuclein in enteric neurons supports the Braak's hypothesis of peripheral origin and vagus nerve-mediated propagation to the brain, supported by the detection of Lewy pathology in gut tissues and experimental evidence from animal models. The “leaky gut” phenomenon is shown to trigger systemic and neuroinflammation, further facilitating alpha-syn aggregation and neuro-degeneration. Dysbiosis is consistently observed in many studies, marked by reduced diversity and diminished populations of SCFA producing bacteria (Prevotella, Faecalibacterium, Roseburia) with corresponding expansion of pro-inflammatory taxa (Akkermansia, Lactobacillus, Enterococcus, Desulfovibrio). Environmental and lifestyle factors—including Western dietary patterns, infections, pesticides, and chronic stress—contribute to the worsening of microbiota profiles and gut barrier function, whereas adoption of Mediterranean or vegetarian diets improvesmicrobial diversity and could decrease disease risk or progression. “Body-first” and “brain-first” pathophysiological subtypes of PD are found to differentiate cases where alpha-synuclein pathology either starts peripherally and spreads centrally or originates in the brain itself, indicating tailored clinical approaches required.Therapeutically, advances in probiotics, prebiotics, fiber-rich dietary strategies, FMT, and innovative pharmacological or neuromodulatory interventions (including GLP-1 agonists, nutraceuticals, and vagus nerve stimulation) offer promising results but still need further research to increase efficacy . Despite exciting progress, several limitations constrain the field: the absence of definitive causal relationships, substantial inter-individual microbiome variability, and short-term, small-scale clinical studies. Biomarker development and clinical translation are hindered by population heterogeneity and methodological inconsistencies. Future research must focus on longitudinal designs tracking microbiota dynamics from early stages, mechanistic clarity of bidirectional GBA signaling, and combination therapies that combine lifestyle, dietary, and advanced medical approaches for optimized patient outcomes. Keywords: Parkinsonism,Gut-Brain Axis,Impact of Gut-Brain-Axis in Parkinsonism, Relationship Between Gut-Brain-Axis in Parkinsonism, Therapeutic Options in Gut-Brain Axis Modulation,Gut to Brain Axis Modulation in Parkinsonism

GLP-1 Agonists and Total Shoulder Arthroplasty Outcomes: Using Natural Language Processing to Assess Postoperative Risks and Complications

Cardiovascular-kidney-metabolic (CKM) syndrome affects approximately 90% of US adults, arising from the convergence of metabolic dysfunction, chronic kidney disease (CKD), and cardiovascular disease (CVD). These conditions create self-reinforcing cycles of multiorgan damage, substantially increasing mortality risk. The American Heart Association's 2023 staging framework stratifies CKM from stage 0 (no risk factors) through stage 4 (clinical CVD with persistent metabolic dysfunction), informing stage-specific interventions. This review synthesizes current evidence on CKM epidemiology, pathophysiology, and disease trajectories. Population-based studies reveal that stage 2 (metabolic risk factors or early CKD) represents the most prevalent category, affecting nearly half of adults in Western cohorts. Progression occurs in 34% of stage 1 individuals, with each stage transition conferring an incrementally higher cardiovascular mortality risk. We describe the biological cascade linking dysfunctional adiposity, insulin resistance, and endothelial dysfunction to renal and cardiac damage, emphasizing bidirectional organ cross talk and the emerging role of hepatic pathology [metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH)] in CKM progression. Finally, we examine stage-specific interventions, from lifestyle modification and weight-loss pharmacotherapy (GLP-1 agonists and dual agonists) in early stages to multidrug cardiorenal protection [sodium-glucose cotransporter-2 (SGLT2) inhibitors and renin-angiotensin-aldosterone system (RAAS) blockade] in advanced disease. This framework allows targeted risk stratification and evidence-based management to interrupt CKM trajectories and improve population health outcomes.

Development and validation of an LC-MS/MS method for Tirzepatide, a dual GIP/GLP-1 receptor agonist, in rat plasma for application to a pharmacokinetic study.

The Role of GLP-1 Agonists in Psoriatic Arthritis: Erratum.

GLP1 receptor analogues and perioperative management considerations: A narrative review.

ABSTRACTIntroductionThe global prevalence of obesity has continued to increase at alarming rates. More recently, there has been an exponential increase in the usage of GLP1 agonists in both clinically obese patients and those seeking weight loss. As a result, there has been an influx of patients who are noticing substantial weight loss and changes to their bodies. Given this surge, it is of utmost importance to have homogeneity in clinical guidelines. A consensus panel was created to discuss clinical scenarios, definitions, and set the stage for the appropriate treatment of patients who have undergone massive weight loss.MethodsTo set standards for nonsurgical rejuvenation of patients at different ages, weight loss patterns, and genders, a consensus panel of 10 panelists was created with advanced expertise and knowledge on this patient population. Each panelist filled out a survey that addressed panelist demographics, including practice patterns and patient demographics, as well as treatment guidelines in both male and female patients. Following the survey, the panelists met to discuss preliminary results and obtain qualitative data to support their conclusions on the criteria.ResultsAll 10 respondents (100%) were able to complete the survey in its entirety. The panel demonstrates the need to assess and address each treatment region individually in these patients. It also emphasizes the need to consider the appropriate range of volumization based on factors such as age, gender, and the degree of weight loss. While the consensus suggests initiating biostimulator treatment concurrently with weight loss to mitigate fat pad deflation and skin laxity, uncertainties remain regarding the optimal timing and dosing.ConclusionIn conclusion, this consensus panel represents the first international effort to provide clinical guidance specifically for patients experiencing medication‐derived weight loss (MDWL). When creating a treatment plan for the MDWL patient, following them throughout the weight loss journey is essential to understand the more global volume changes that they may be observing.

Abstract Aim The aim of the study was to evaluate the impact of preoperative GLP-1 agonist medication on postoperative weight-loss outcomes during the first 12 months after bariatric surgery. Method A retrospective, single-centre, cohort study was conducted. A total of 85 adult patients, who underwent primary bariatric surgery (Sleeve Gastrectomy, Roux-en-Y Gastric Bypass, Mini Gastric Bypass) between January and December 2023 and were started on GLP-1 agonists six months before surgery, were included. Patients were grouped based on preoperative use (n=36) or non-use (n=49) of GLP-1 agonists. Primary outcome assessed was the percentage of excess weight loss (%EWL) at 12 months post operative. Statistical analysis was performed using the Mann-Whitney U test. Results Patients using GLP-1 agonists demonstrated significantly greater preoperative excess body weight loss compared to non-users (12.64% vs 6.95%, p=0.015). However, at 12 months postoperative, no significant statistical differences in % EWL between groups, Sleeve Gastrectomy (55.6% vs 48.1%, p=0.148), Mini Gastric Bypass (53.53% vs 51.51%, p=0.356), or Roux-en-Y Gastric Bypass (61.9% vs 56.02%, p=0.148), was noted. Conclusions Although preoperative use of GLP-1 agonists offers in improved weight reduction in preoperative time, but it did not demonstrate any superior short term postoperative weight loss outcomes for bariatric surgery patients. A multi-centre, prospective study having larger sample size with long term follow up may be required to establish and measure long-term implications.

Can GLP-1 agonists be used safely in inflammatory bowel disease? A meta-analysis.

Overview of: Faculty of Sexual and Reproductive Healthcare. FSRH statement: Glucagon-like peptide-1 (GLP-1) agonists and oral contraception [online], 2025. Available: https://www.cosrh.org/Public/Documents/FSRH-statement-Glucagon-like-peptide-1-agonists-and-oral-contraception-Feb-2025.aspx [Accessed 26 September 2025].