Why in News :
Novo Nordisk’s semaglutide and Eli Lilly’s tirzepatide — two GLP-1-based injectable drugs for weight loss and diabetes management — have been introduced in India.These drugs have shown 15–20% weight loss, comparable to bariatric surgery, and are being studied for other health benefits.
What are GLP-1 Drugs?
GLP-1 (Glucagon-like Peptide-1) receptor agonists mimic gut hormones (incretins) to:
- Enhance insulin secretion.
- Suppress glucagon (reduces liver glucose release).
- Slow gastric emptying (reduces blood sugar spikes).
- Suppress appetite and increase satiety.
- Tirzepatide also mimics GIP (glucose-dependent insulinotropic polypeptide).
Timeline & Development
- Incretins known since 1906, but insulin discovery in 1921 delayed research.
- GLP-1 discovered in 1986; early trials showed promise but lacked compound stability.
Novo Nordisk overcame this, leading to:
- Liraglutide (daily injectable) – initial breakthrough.
- Semaglutide (weekly injectable) – more effective with fewer side effects.
- Tirzepatide added dual action and gained faster traction.
Health Benefits Beyond Weight Loss
- Cardiovascular: 20% reduction in heart attacks/strokes; 69% reduction in heart failure.
- Metabolic: Helps in Type-2 diabetes, fatty liver disease (63% improvement), and fibrosis.
- Neurological: Emerging evidence shows reduction in Alzheimer’s risk and food/alcohol addiction.
- Sleep disorders: Tirzepatide approved for obstructive sleep apnea.
Limitations & Ethical Issues
Cost barrier in India:
- Semaglutide: ₹17,345–₹26,015/month depending on dose.
- Tirzepatide: ₹13,500–₹17,000/month.
- Side effects: Nausea, vomiting, gastric discomfort.
- Contraindicated: In thyroid cancer history, pregnancy, or growing children.
- Social risk: May fuel body image obsession or off-label cosmetic use.
Future Potential & R&D
Newer molecules under trial:
- Retatrutide (targets GLP-1, GIP, glucagon).
- CagriSema (GLP-1 + Amylin receptor).
- Survodutide & Mazdutide (dual GLP-1 + glucagon).
- Oral forms: Orforglipron, Danuglipron.
- Research shifting to monthly injectables and more accessible oral therapies.
| UPSC Relevance GS2 – HealthPublic health policy, obesity epidemic, preventive healthcare GS3 – Science & TechBiopharmaceutical innovation, indigenous availability, regulatory approvals GS4 – EthicsEquity in access to life-altering drugs, marketing vs medicine Mains Practice Question Q. GLP-1 receptor agonists are being hailed as a breakthrough in modern medicine. Critically examine their role in public health with reference to opportunities and challenges in India.(Answer using dimensions: effectiveness, affordability, ethics, accessibility, R&D ecosystem) |
