Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2024; 15(11): 2167-2172
Published online Nov 15, 2024. doi: 10.4239/wjd.v15.i11.2167
Published online Nov 15, 2024. doi: 10.4239/wjd.v15.i11.2167
Glucagon-like peptide-1 agonists: Role of the gut in hypoglycemia unawareness, and the rationale in type 1 diabetes
Hyder O Mirghani, Internal Medicine, University of Tabuk, Tabuk 51941, Tabuk, Saudi Arabia
Author contributions: Mirghani HO conceived and designed the study, performed the literature search, drafting, critical revision, and provided final approval of the version to be published.
Conflict-of-interest statement: The author declared that there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyder O Mirghani, MD, Professor, Internal Medicine, University of Tabuk, Prince Fahd Bin Sultan, Tabuk 51941, Tabuk, Saudi Arabia. s.hyder63@hotmail.com
Received: July 12, 2024
Revised: August 30, 2024
Accepted: September 5, 2024
Published online: November 15, 2024
Processing time: 95 Days and 21.5 Hours
Revised: August 30, 2024
Accepted: September 5, 2024
Published online: November 15, 2024
Processing time: 95 Days and 21.5 Hours
Core Tip
Core Tip: Poor glycemic control, nonadherence to insulin, vascular complications, and obesity remain major challenges in type 1 diabetes management. Glucagon-like peptide-1 receptor (GLP-1) agonists have been shown to address the above issues without significant hypoglycemia. The rationale for GLP-1 agonist use is based on the shared pathophysiology of type 1 and type 2 diabetes. The recent evidence of gut involvement in GLP-1 agonists induced hypoglycemia unawareness and glucagon dysregulation is of great concern and the emerging role of GLP-1 agonists in gut microbiota dysregulation and diversity could change diabetes management including type 1 diabetes. The use of GLP-1 agonists should be individualized.