DOI: https://doi.org/10.36347/sasjm.2026.v12i10.014

Pages: 1098-1105

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with substantial cardiovascular and renal complications. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as important therapeutic agents because of their glucose-lowering effects, weight reduction, and potential cardiorenal benefits. Objective: This narrative review examines the pathophysiological rationale, clinical impact, efficacy, safety, and evidence-based management of GLP-1 RAs in adults with T2DM. Methods: Relevant literature published between 2015 and 2026 was reviewed using focused searches of biomedical literature and relevant clinical guidelines. Randomized controlled trials, meta-analyses, and contemporary recommendations were considered to evaluate glycemic outcomes, weight management, cardiovascular and kidney protection, and treatment-related safety concerns. Results: GLP-1 RAs enhance glucose-dependent insulin secretion, suppress inappropriate glucagon release, delay gastric emptying to varying degrees, and promote satiety. Clinical trials have demonstrated improvements in glycated hemoglobin and body weight, while several agents have reduced major adverse cardiovascular events in populations with T2DM and elevated cardiovascular risk. Emerging evidence also supports kidney-protective effects for selected agents. However, gastrointestinal adverse effects, treatment cost, accessibility, contraindications, and differences between individual drugs may influence treatment selection and long-term adherence. GLP-1 RAs should be selected according to individual clinical characteristics, comorbidities, treatment goals, and patient preferences. Conclusion: GLP-1 RAs represent a valuable component of contemporary T2DM management, offering benefits beyond glycemic control for appropriately selected patients. Individualized prescribing, careful safety assessment, and integration with lifestyle interventions and other evidence-based therapies are essential t