University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Dr. Thomas Colletti


Type 2 diabetes (T2DM) is a chronic medical condition affecting millions of individuals worldwide. The burden of disease is significant as demonstrated by high morbidity and mortality rates and billions of healthcare dollars spent. The pathophysiology of T2DM is complex with eight primary deficits known as the ominous octet. Treatment should be guided accordingly. In recent years, a focus has been placed on incretin hormones such as glucagon-like peptide 1 (GLP-1) and its glucose lowering benefits. GLP-1 is secreted in the gut in response to an oral glucose load and helps to lower fasting and post-prandial blood sugars. Research suggests there are numerous other benefits in addition to glycemic lowering and A1C reduction. Several FDA-approved glucagon-like peptide receptor agonists (GLP-1 RA) are available in the United States for the treatment of type 2 diabetes. These are once daily liraglutide or lixisenatide, or once weekly exenatide, dulaglutide, or semaglutide. Semaglutide also comes in a once daily oral formulation. In addition to improving glycemic control, GLP-1 RA have been shown to lower total body weight, blood pressure, cholesterol, and improve renal function and beta cell proliferation. These agents should be considered in every patient with type 2 diabetes due to their substantial clinical benefits and potential to help lower the burden of disease in the US and worldwide.


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