GLP-1 Medicines:
What’s New, and What’s Next?
Apparently, November is Diabetes Awareness Month. So, we thought it would be a good time to revisit the class of medications that have changed the game for treatment of both type 2 diabetes and obesity. Here’s what’s new and what’s coming.
GLP-1 medicines moved from niche diabetes therapy to household name in record time. The attention is deserved, but so is careful guidance. If you or someone you love is managing type 2 diabetes or medical obesity, here’s the state of play for late 2025 and what you can expect in 2026.
How widely are people using them now?
Use has accelerated. A national CDC analysis estimates that in 2024, about twenty-six percent of US adults with diagnosed diabetes used an injectable GLP-1, roughly 6.9 million people. Utilization rose with age and varied by insurance and income.
Outside of diabetes care, interest is broad. A KFF tracking poll found that about one in eight US adults report having used a GLP-1 drug, with about six percent using one currently. Use is much higher among people with diabetes and heart disease, but affordability remains a barrier for many.
How GLP-1 Agonists Work
It’s all about hormones! GLP-1 agonists make us feel like we’ve just eaten even when we haven’t. Semaglutide drugs, like Ozempic and Wegovy and liraglutide drugs like Victoza and Saxenda, do this by mimicking the action of one of our satiety hormones called glucagon-like peptide 1 (GLP-1). They slow the movement of food from the stomach into the small intestine. As a result, you feel full faster and longer, so you eat less.
Other GLP-1 agonists, tirzepatides like Mounjaro and Zepbound, trigger an additional satiety hormone called GIP. This is why these drugs can achieve more weight loss than semaglutides.
GLP-1 agonists also help trigger the production of more insulin. Generally, when we eat, our blood sugar levels start to rise, and our bodies produce insulin to help lower those blood sugar levels. Diabetics, as well as many obese and overweight individuals, have something known as insulin resistance. It means the body does not react properly to the ingestion of food and becomes unable to produce the appropriate amount of insulin in response. GLP-1 agonists help our bodies reset our leptin and insulin responses, which is why they work so well to help diabetics lower their A1C levels.
Research has found that some drugs in these groups may lower the risk of heart disease, such as heart failure, stroke, and kidney disease. People taking these drugs have seen their blood pressure and cholesterol levels improve even before they have lost a significant amount of weight. This is because GLP-1 agonists appear to have anti-inflammatory properties. Many diseases are caused or exacerbated by inflammation, and carrying extra weight causes a chronic low level of inflammation. GLP-1 agonists reduce inflammation on their own and further reduce inflammation by causing weight loss.
Those Side Effects
Most people feel some nausea or GI upset early on that settles with a slow dose ramp. Low blood sugar is uncommon unless you also take insulin or a sulfonylurea.
Procedures with anesthesia require planning because slower gastric emptying raises aspiration risk. Elective procedures generally involve holding injections in advance; always coordinate timing with your surgeon and prescribing clinician. These safety points continue to be important in 2026 and beyond.
Looking ahead to 2026: What’s in the pipeline?
Several next-generation options are on track that could improve efficacy and/or convenience. It is likely that the side effects will not be eliminated in the foreseeable future.
- Orforglipron pill, Eli Lilly. This is an oral small-molecule GLP-1 medication currently finishing several types of phase 3 trials. The once-a-day pill is being studied for obesity under the name Attain and for type 2 diabetes under the trial name Achieve. Attain-2 studies have been conducted on patients who have both conditions. Trials show Orforglipron is quite effective for weight-loss and type 2 diabetes management compared to a placebo, though some suggest it might be slightly less effective than some injectable GLP-1 agonists. If approved, this daily pill should be the first oral GLP-1 agonist available in 2026.
- Retatrutide, Eli Lilly. This weekly injection is called a triple-pathway agonist because it targets three different satiety and digestive hormone receptors: GLP-1, GIP, and glucagon receptors. Early phase 3 trials are showing significant weight reduction, but dosing, tolerability, and long-term safety will guide labeling. If approved, Retatrutide will be available in late 2026 or early 2027.
- CagriSema, Novo Nordisk. CagriSema is a combination of two medications, cagrilintide and semaglutide, which like Retatrutide is targeting glucagon receptors in addition to satiety hormones. Novo Nordisk plans an FDA filing in early 2026 for treatment of both obesity and type 2 diabetes, contingent on data and manufacturing readiness. If approved, the once-weekly injection could be available in late 2026.
- MariTide, Amgen. Amgen is developing a monthly GLP-1–based injection which activates the GLP-1 receptor like the others in this class, but blocks the GIP receptor, which is the opposite mechanism of action to Retatrutide and CagriSema. Phase 3 trials under the seaworthy name, MariTime, will continue into 2026. MariTide’s long half-life is what allows for monthly rather than weekly injections. If approved, patients will be able to enjoy the convenience of monthly injections by 2027.
Important Note About Pipeline Medications
Currently, there are no GLP-1 oral medications or versions of Retatrutide that have been approved by the FDA in this country. Still, some enterprises are making oral GLP-1 agonists and Retatrutide available online. This is not the same thing as compounded versions of approved drugs. The FDA makes it clear that Retatrutide and cagrilintide cannot be used in compounding under federal law. Additionally, these are not components of FDA-approved drugs and have not been found to be safe and effective for any condition.
Access, Coverage, and Cost
Amaze medical provider Julia Ball leads our primary care team. She explains, “Many insurers will cover GLP-1 agonists for type 2 diabetes patients who have not achieved glycemic control with other oral medications or insulin.”
She adds that as this class of drugs gets broader approvals, the branded medications may be covered for some obesity patients with other conditions. “While not all GLP-1s have the same uses, a few specific ones are now approved for lowering cardiovascular risk in people with obesity or type 2 diabetes, and some are even cleared to help treat moderate to severe sleep apnea—showing just how far these medications have come beyond blood sugar and weight control.”
Still, Julia says most weight-loss patients are still going with lower-cost options. “I would estimate that at least 75% of our GLP-1 weight loss patients end up on compounded medication due to lack of insurance coverage. Some choose to pay for the brand, but it is pricey. Those taking it for weight loss should be prepared to pay out-of-pocket compounded cost if they are serious about pursuing a GLP-1 agonist. Our team of healthcare providers here at Amaze are trained to carefully evaluate each patient’s medical history and individual risk factors before prescribing GLP-1 agonists to ensure safety and efficacy.”
Contraindications
Julia also explained that you may not be a candidate for treatment with a GLP-1 agonist if you have the following:
- History of hypersensitivity or severe allergic reactions to GLP-1 agonists or any of the components in the medication.
- Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Severe gastrointestinal disease, such as gastroparesis or inflammatory bowel disease, as GLP-1 agonists can exacerbate these conditions.
- History of pancreatitis or a high risk of pancreatitis.
- Severe renal impairment or end-stage renal disease.
- Pregnancy or breastfeeding, as the safety of GLP-1 agonists in pregnant or lactating women has not been established.
If you are using a GLP-1 for obesity without diabetes, the medicine works best alongside strength training, adequate protein, and sleep. This combination helps protect lean mass and maintain weight loss if a dose interruption occurs. If you plan to have a procedure with anesthesia, bring your medication schedule to your pre-op appointment so the team can advise when to pause.
If you are deciding whether to start, ask three questions:
- What is my primary goal: A1C reduction, weight loss, or cardiometabolic risk reduction?
- What does my insurance cover now, and what documentation helps authorization?
- If I respond well, am I prepared for long-term therapy, and do I have a plan if I need to stop?
Bottom Line
For diabetes, GLP-1 medicines have quickly become a mainstay, and many people also see improvements in weight, blood pressure, and cholesterol. Use is widespread and growing, and the next wave of options may add convenience and potency in 2026. Decisions should still be individualized with your clinician, especially around procedures, other medications, and long-term plans.
