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Incretin Mimetics (Diabetes Management)

Nursing Knowledge

Incretin Mimetics (Diabetes Management)

Incretin mimetics and other non-insulin injectable diabetes medications represent an expanding class of drugs in diabetes management. Unlike insulin, which directly replaces or augments a deficient hormone, these agents, including GLP-1 agonists and amylin analogs, harness alternative pathways to regulate blood glucose. They can aid in glycemic control, weight loss, and carry a low risk of hypoglycemia. As with insulin therapies, patient education on proper injection technique and storage is essential.
Last updated: December 4, 2023

Table of contents

What are incretin mimetics? 

Incretin mimetics, or GLP-1 receptor agonists, are a class of medications used to treat type 2 diabetes (off-label for type 1). They mimic the action of incretins, which are natural hormones in the body. Examples of incretin mimetics include liraglutide, exenatide, semaglutide, and dulaglutide. 

Adverse effects of incretin mimetics

Potential adverse effects of incretin mimetics include: 

  • Hypoglycemia when taken with insulin
  • GI distress
  • Pancreatitis
  • Renal insufficiency
  • Possible risk of thyroid cancer

Other non-insulin, injectable diabetes medications 

GIP/GLP-1 receptor co-agonists 

GIP/GLP-1 receptor co-agonists are used to treat type 2 diabetes only. They can have adverse effects including: 

  • Hypoglycemia when taken with insulin
  • GI distress
  • Renal insufficiency
  • Pancreatitis
  • Possible risk of thyroid cancer

Amylin mimetics 

Amylin mimetics are a group of medications used to treat type 1 and type 2 diabetes. 

Potential adverse effects of these drugs include hypoglycemia (when taken with insulin), GI distress, and injection site reactions. 

Mechanism of action

All non-insulin, injectable diabetes medications work by 

  • Slowing gastric emptying/decreasing gastric motility
  • Stimulating the release of insulin with glucose
  • Suppressing glucagon release after a meal
  • Suppressing appetite/increasing satiety

Client education points

General teachings

  • Do not inject into the same site as insulin.
  • Immediate-release medications must be taken 60 minutes prior to a meal, not after. 
  • Educate clients how to use their specific device to avoid incorrect dosing. 
  • Do not double dose if missed. 
  • These medications may interfere with oral contraceptives. 
  • Educate the client on risks of hypoglycemia if using insulin. 

Client teachings about incretin mimetics 

  • SubQ injection prior to meals (immediate release) or once weekly (extended release)
  • Can affect absorption of oral medications

Client teachings about GIP/GLP-1 receptor co-agonists 

  • Once-weekly subQ injection
  • Can affect absorption of oral medications
  • In response to carbohydrates, GIP and GLP-1 cause insulin release and decrease glucagon secretion.
  • In euglycemic or hypoglycemic states, GIP causes an increase in glucagon secretion.

Client teachings about amylin mimetics 

  • SubQ injection prior to meals
  • Used w/ mealtime insulin
  • Can affect absorption of oral medications

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Incretin Mimetics (Diabetes Management)

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Review of injectable non-insulin medications, including mechanism of action, side effects, dosing, and client education.

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