GLP-1 medications have come a long way since the first one became available in 2005, and the next generation could bring even more options for people living with diabetes. From pills to medications that combine multiple hormones, GLP-1s continue to evolve beyond glucose management and weight loss.

In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus discuss how GLP-1 medications have evolved and where they may be headed next. They look back at the progression from early twice-daily injections to once-weekly therapies and explain how the role of GLP-1s has expanded from managing glucose to supporting weight management, cardiovascular health, kidney health, and other areas of metabolic health.

The conversation explores newer oral GLP-1 options and what taking a pill instead of an injection could mean for people who prefer that option. Dr. Edelman and Dr. Pettus also discuss the next generation of therapies that combine GLP-1 with hormones such as glucagon–and amylin. They explain why researchers are combining these different hormones, how they may affect weight and glucose, and why getting to the highest possible dose isn’t necessarily the goal for everyone.

They also address some of the practical questions that come with taking a GLP-1, including side effects, cost, insurance coverage, and whether these medications need to be taken long term. The discussion covers nausea and other GI side effects, concerns about losing muscle and lean mass during significant weight loss, and why getting enough protein and staying physically active can be important. They also explain what can happen when GLP-1 therapy is stopped, including the possibility of regaining weight.

Finally, Dr. Edelman and Dr. Pettus discuss what GLP-1 medications could mean for people living with type 1 diabetes. They share their clinical experience using these medications in people with type 1 diabetes for other indications and discuss ongoing research looking at their potential effects on weight, insulin needs, A1C, and glucose variability. They also look at how future approvals could affect insurance coverage and what continued innovation may mean for people living with diabetes.