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Foundations

The GLP-1 pathway

One hormone, one receptor, and the piece of biology that half this catalogue is built on. Get this page straight and the compound pages that follow become considerably easier to read.

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Molecular structure model on a laboratory screen
The hormone

Released by the gut, cleared in minutes

Glucagon-like peptide 1 is produced by cells in the intestinal wall and released when food arrives. It is an incretin: a gut hormone that signals to the pancreas that glucose is on its way, so insulin release can begin before blood sugar has fully risen.

Its working life is extremely short. The enzyme DPP-4 cleaves it within a couple of minutes, which is appropriate for a meal signal and hopeless for a therapeutic. Every compound in this class exists because of that clearance problem.

The receptor it acts on is not confined to the pancreas. It appears in the brain, in the gastrointestinal tract and elsewhere, and that distribution is why activating it does considerably more than adjust insulin.

One detail explains more than it seems to. The hormone and glucagon are cut from the same precursor protein, proglucagon, by different enzymes in different tissues: the pancreas releases glucagon from it and the intestinal cells release GLP-1. Two hormones with broadly opposing effects on blood glucose share a gene, which is part of why one engineered peptide can be made to reach both receptors. The receptor entry on UniProt lists where it is expressed, and that tissue list is the short version of everything the next section describes.

Four effects

What receptor activation does

The same receptor, in four different places, doing four different things.

  1. 01

    Glucose-dependent insulin release

    Insulin secretion increases when blood glucose is high and largely stands down when it is not. That dependence is why this class carries less hypoglycaemia risk than older approaches.

    The compound with the deepest data
  2. 02

    Suppressed glucagon

    Glucagon raises blood glucose. Reducing its release while increasing insulin moves the same variable from two directions at once.

    The compound that re-adds glucagon
  3. 03

    Slowed gastric emptying

    Food leaves the stomach more slowly. This contributes to the effect on intake and accounts for a good deal of the reported gastrointestinal experience.

    What that means in practice
  4. 04

    Central appetite signalling

    Receptors in the hypothalamus and brainstem participate in appetite regulation. This is the route most of the weight findings run through.

    The weight research area
Building on it

How the class has developed

The first generation solved the clearance problem, mostly by attaching fatty acid chains that bind the molecule to albumin and slow its removal. Liraglutide reached about half a day; semaglutide reached about a week.

The second generation added receptors. Tirzepatide combined GLP-1 with GIP, the other incretin, and outperformed GLP-1 alone in head-to-head trials. Retatrutide added glucagon on top of both, which brings energy expenditure into a picture that was previously about intake.

Each step has less published evidence behind it than the last. That is not a criticism, it is what newer means, but it is worth holding in mind when you see effect sizes from different generations quoted side by side.

The compound pages carry the detail generation by generation. The liraglutide page covers the daily first-generation compound, the tirzepatide page the dual agonist that brought GIP back into the picture, and the receptor agonist literature indexed on PubMed holds the trial reports themselves. Read the class in that order and each step makes sense as an answer to the limits of the one before.

Keep straight
  • GLP-1 the hormone, GLP-1 the classThe same name covers a natural hormone and a family of engineered analogues. They are not interchangeable.
  • GIP is a different hormoneThe other incretin, with its own receptor. Dual agonists engage both; it is not a stronger GLP-1.
  • GLP-3 is not in this familyNo such receptor exists. It is a market label, generally applied to triple-agonist material.
  • Half-life is not potencyA weekly compound is not stronger than a daily one. It is cleared more slowly, which is a different property.
From the catalogue

This class in the catalogue

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Keep reading

Follow the class

Where to go once the pathway makes sense.

Compound

Semaglutide

The weekly agonist with the largest trial record.

Read
Compound

Retatrutide

Three receptors from one molecule.

Read
Comparison

Retatrutide vs tirzepatide vs semaglutide

The three side by side, on evidence.

Read
Questions

About the pathway

Four questions that clear up most of the confusion here.

Why does natural GLP-1 last only minutes?
DPP-4 cleaves it almost immediately. That is appropriate for a meal signal and useless for a therapeutic, which is why every compound in the class is engineered around it.
What does glucose-dependent mean?
Insulin release increases when blood glucose is high and largely stands down when it is not. The effect follows the glucose rather than running regardless of it.
Is GIP part of the GLP-1 pathway?
No. It is a separate incretin with its own receptor. Dual agonists engage both, which is different from engaging GLP-1 more strongly.
Where does GLP-3 fit?
It does not. There is no GLP-3 receptor. The term is a market designation, usually applied to triple-agonist material; the GLP-3 page explains what the name covers in this catalogue and what it does not.
Next step

Read the compounds themselves

The pathway is the frame. The compound pages are where the actual evidence, and its limits, are set out one by one.

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