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Biological actions of GLP-1, source: reference [1] Evolution of GLP1 GLP-1RAs Currently, there are nine GLP-1RAs approved for marketing worldwide (Table 1), mainly for the treatment of diabetes and obesity, of which tirzepatide is a novel dual GLP-1RA/GIPR agonist

Patient monitoring should include: Baseline lipid panel, hemoglobin A1c, and liver function tests Blood pressure monitoring (GLP-1 agents typically reduce systolic BP by 3-5 mmHg) [10] Assessment for gastrointestinal adverse effects during dose titration Evaluation for contraindications (personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2) [1] [3] Monitoring for gallbladder disease (increased risk with rapid weight loss) In patients with diabetes and retinopathy, monitoring for worsening eye symptoms, particularly with rapid glycemic improvement Renal function assessment, especially if severe gastrointestinal symptoms cause dehydration Patients should seek immediate medical attention for severe abdominal pain, which may indicate pancreatitisa rare but serious adverse effect

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