Your GLP-1 starter guide
Healthcare providers have been using GLP-1 drugs to treat type 2 diabetes since 2005. Providers are now prescribing GLP-1 medications to support people on their weight loss journeys too. These drugs can have life-changing benefits when used safely. We created this guide to help you learn more about what they are, how to get started and what to expect if you go on one. Consult manufacturer labeling for specific prescribing information.
GLP-1 is short for glucagon-like peptide-1 agonist. They’re also known as incretin mimetics or GLP-1 analogs. This class of drugs was first used to treat type 2 diabetes. Some GLP-1s are now approved for use in the treatment of obesity as well.
GLP-1 drugs include, but are not limited to:
- Dulaglutide (Trulicity)
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Saxenda, Victoza)
- Tirzepatide (Mounjaro)
How does GLP-1 medication work?
Glucagon-like peptide-1 (GLP-1) is a hormone released by the lower GI tract every time you eat. This hormone:
- Impacts the parts of your brain that causes you to feel hungry or satisfied
- Slows down digestion
- Triggers the pancreas to release insulin and slow down the release of glucagon; this helps keep blood sugar in balance
GLP-1 drugs work by mimicking the action of the GLP1 hormone your body produces naturally. GLP-1 drugs bind to the GLP-1 receptors in your gut and act just like the hormone produced by your body. The drugs slow down digestion and signal for your pancreas to release more insulin and less glucagon. This results in decreased spikes in blood sugar. Appetite is also reduced. The result: You eat less, which leads to weight loss.
Who shouldn’t take a GLP-1 drug?
GLP-1 drugs are not recommended for people with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia 2A or 2B. Since GLP-1 drugs slow gastric emptying, they shouldn’t be used in people with gastroparesis. Make sure your care provider is aware of your medical history and any other drugs you may be taking.
Heart health bonus
Research finds that GLP-1 drugs can reduce blood pressure and inflammation in the blood vessels. They even cut the risk of major cardiovascular events like stroke and heart attack in people with type 2 diabetes and people with obesity.
Considerations before starting a GLP-1 drug
Side effects and risks
Taking any drug comes with possible side effects and risks.
Possible side effects of GLP-1 drugs include:
- Impacts the parts of your brain that causes you to feel hungry or satisfied
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Loss of muscle
- Changes in appetite and food preferences
- Changes in mood; many experience mood improvements, but some report suicidal thoughts
More rare risks include:
- Low blood sugar (hypoglycemia)
- Inflammation of the pancreas (pancreatitis) that can cause swelling or pain
- Injection site reactions, like rash or itching
- Delayed gastric emptying (gastroparesis), a short and temporary symptom that will resolve for most individuals
- Gall bladder/biliary diseases
- Anaphylaxis, which is a severe allergic reaction requiring immediate medical attention
If you experience any symptoms, talk to your doctor right away. In the event of any medical emergency, call 911.
Cost
GLP-1 drugs can be costly. So we encourage you to have a good understanding of what your out-of-pocket costs will be before moving forward with any drug.
Insurance coverage
Your insurance may cover GLP-1 meds. It varies by provider and plan. It’s important to call your insurance company to find out which medications, if any, are covered. If the drugs are covered, ask if you need to get prior authorization or are required to meet certain criteria for this coverage.
Patient assistance programs (PAP)
Some drug companies offer PAP. If you meet certain qualifications, you may be able to get GLP-1s at low or no cost for a period of time. Contact the drug company of the prescribed GLP-1 med to learn more. If you qualify, be sure to ask for how long this program will cover your costs.
Long-term use
Whether used for weight management or diabetes, GLP-1 drugs are not a quick fix or one-time solution. You’ll need to stay on these drugs for as long as you want the benefits to continue. If you stop, weight regain is likely to occur.
How to get started on a GLP-1 drug
When can I start a GLP-1 drug?
Each GLP-1 drug is a little different. So it’s important to ask your care provider or pharmacist any specific questions you may have. If you decide to move forward with a GLP-1 drug and you’re not on any other medication, you can get started when you please. If you’re already on a medication for diabetes like metformin or insulin, talk to your doctor about the best time to add in your GLP-1. *Pro tip: If your GLP-1 drug is weekly, create a consistent routine by picking and sticking to a day and time that works for you.
What’s the right dose to take?
GLP-1 meds are usually started at low doses. This helps to prevent gastrointestinal side effects like nausea and constipation. With your care provider’s supervision, you will gradually increase the dose until the most effective, well-tolerated dose is reached. It can take anywhere from weeks to months to get to the optimal level. You may see your blood sugar improve within a few weeks. Weight loss will depend on changes you are also making to how you eat and how much activity you are getting; being on a GLP-1 drug may make it easier to make these changes.
Do Teladoc Health care providers prescribe GLP-1 drugs for weight loss?
Teladoc Health care providers can prescribe GLP-1 meds for weight loss when clinically appropriate and permitted by state regulations. They’ll evaluate your situation and decide if GLP-1 drugs are a good fit. GLP-1 drugs may not be for everyone. Some of their considerations include:
- If you are eligible for Primary Care, or
- If you are enrolled in one of our Condition Management programs and your plan includes virtual care
- If you’ve tried to lose weight through lifestyle changes but have not been successful
GLP-1 meds are not available through 24/7 Care (General Medical). This is because these visits are for short-term conditions like a cold. They are not meant to treat chronic conditions or provide long-term care. Using a GLP-1 drug requires an ongoing patientprovider relationship. This must include regular followups to ensure that it’s safe and effective.
How do I take a GLP-1 drug?
Some GLP-1 drugs are given by self-injection, while others are in pill form. Here are some tips on how to be successful with each type of medication:
Injections:
Follow storage instructions on the package.
- Inject into the abdomen (a few inches away from the belly button), outer thighs, hips, upper buttocks, lower back or upper arm.
- Wash hands before and after. • If you also use insulin, inject this drug in a different spot.
- Throw away in a sharps/needle box.
Oral medication (pills):
- Follow instructions from your pharmacist.
- May need to be taken on an empty stomach, at least 30 minutes before any food in the morning.
- Do not break or crush pill.
- Take according to your prescription—don’t skip a dose.
Special considerations:
- Some GLP-1 drugs have specific timing needs. For instance, it’s recommended to take Rybelsus at least 30 minutes before your first meal, with no more than 4 ounces of water.
- Talk to your pharmacist to learn more about the safest and most effective way to take any drug you’re on.
Do I still need to think about diet and exercise?
Absolutely! Eating well and moving your body, along with getting high-quality sleep and managing your mental health, are important tools in managing both diabetes and weight. This is true whether you’re on a GLP-1 drug or not. People often find it easier to do these things with the support of a GLP-1. Many report that being on GLP-1 drugs reduces their level of “food noise.” With fewer intrusive thoughts about food, it’s easier to make balanced choices.
The Balanced Plate is a good framework to use. A balanced plate has 50% non-starchy veggies, 25% lean proteins and 25% carbs.
Keeping your body active is another important tool for staying well. Any form of movement that you enjoy and can fit into your day is a good choice.
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This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.