GLP-1 AND DUAL GLP-1/GIP RECEPTOR AGONISTS AS NEUROPROTECTIVE AGENTS: MECHANISMS, CLINICAL EVIDENCE, AND TRANSLATIONAL PERSPECTIVES

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6110

Keywords:

Brain Insulin Resistance, GLP-1 Receptor Agonists, Neuroinflammation, Alzheimer’s Disease, Parkinson’s Disease, Healthy Aging

Abstract

Background: Neurodegenerative diseases are increasingly linked to metabolic dysfunction, such as impaired insulin signaling, mitochondrial dysfunction, oxidative stress, and chronic neuroinflammation. These observations have contributed to the type 3 diabetes hypothesis, which describes AD as a disorder associated with brain insulin resistance. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual GLP-1/GIP receptor agonists have emerged as promising therapeutic candidates because of their metabolic and neuroprotective properties.

Objective: To evaluate the neuroprotective potential of GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists in neurodegenerative diseases.

Materials and Methods: A structured narrative review was conducted using PubMed, Scopus, and Web of Science databases. Studies published between 2015 and 2026 investigating incretin-based therapies in neurodegenerative disorders were included, encompassing randomized controlled trials, observational studies, meta-analyses, and mechanistic research.

Results: Preclinical studies consistently demonstrated neuroprotective effects of GLP-1RAs through modulation of neuroinflammation, oxidative stress, mitochondrial dysfunction, synaptic plasticity, and neuronal survival pathways. Observational studies suggested an association between incretin-based therapies and reduced dementia risk. Clinical trials in AD and PD have yielded heterogeneous results, with efficacy appearing to depend on disease stage and patient characteristics. Dual GLP-1/GIP receptor agonists showed promising mechanistic potential, although clinical evidence remains limited.

Conclusions: Incretin-based therapies represent a promising multi-target strategy for neurodegenerative diseases. Their effects extend beyond glycaemic regulation and may influence multiple pathways involved in neurodegeneration. Further large-scale clinical studies are required to determine their disease-modifying potential and optimal therapeutic use.

References

Athauda, D., Greig, N. H., Meissner, W. G., Foltynie, T., & Gandhi, S. (2026). The promise of GLP-1 receptor agonists for neurodegenerative diseases. The Journal of Clinical Investigation, 136(4). https://doi.org/10.1172/JCI194745

Baggio, L. L., & Drucker, D. J. (2007). Biology of incretins: GLP-1 and GIP. Gastroenterology, 132(6), 2131–2157. https://doi.org/10.1053/J.GASTRO.2007.03.054

De Felice, F. G., Lourenco, M. V., & Ferreira, S. T. (2014). How does brain insulin resistance develop in Alzheimer’s disease? Alzheimer’s & Dementia, 10(1), S26–S32. https://doi.org/10.1016/J.JALZ.2013.12.004

De La Monte, S. M., & Wands, J. R. (2008). Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed. Journal of Diabetes Science and Technology (Online), 2(6), 1101. https://doi.org/10.1177/193229680800200619

Du, H., Meng, X., Yao, Y., & Xu, J. (2022). The mechanism and efficacy of GLP-1 receptor agonists in the treatment of Alzheimer’s disease. Frontiers in Endocrinology, 13, 1033479. https://doi.org/10.3389/FENDO.2022.1033479/FULL

Edison, P., Femminella, G. D., Ritchie, C., Nowell, J., Holmes, C., Walker, Z., Ridha, B., Raza, S., Livingston, N. R., Frangou, E., Love, S., Williams, G., Lawrence, R., Mcfarlane, B., Archer, H., Coulthard, E., Underwood, B. R., Koranteng, P., Karim, S., … Ballard, C. (2025). Liraglutide in mild to moderate Alzheimer’s disease: a phase 2b clinical trial. Nature Medicine 2025 32:1, 32(1), 353–361. https://doi.org/10.1038/s41591-025-04106-7

Feigin, V. L., Vos, T., Nichols, E., Owolabi, M. O., Carroll, W. M., Dichgans, M., Deuschl, G., Parmar, P., Brainin, M., & Murray, C. (2020). The global burden of neurological disorders: translating evidence into policy. The Lancet. Neurology, 19(3), 255–265. https://doi.org/10.1016/S1474-4422(19)30411-9

Fukuda, M. (2021). The Role of GIP Receptor in the CNS for the Pathogenesis of Obesity. Diabetes, 70(9), 1929. https://doi.org/10.2337/DBI21-0001

Gandhi, A., & Parhizgar, A. (2025). GLP-1 receptor agonists in Alzheimer’s and Parkinson’s disease: endocrine pathways, clinical evidence, and future directions. Frontiers in Endocrinology, 16, 1708565. https://doi.org/10.3389/FENDO.2025.1708565/TEXT

Hölscher, C. (2020). Brain insulin resistance: role in neurodegenerative disease and potential for targeting. Expert Opinion on Investigational Drugs, 29(4), 333–348. https://doi.org/10.1080/13543784.2020.1738383

Holst, J. J. (2007). The physiology of glucagon-like peptide 1. Physiological Reviews, 87(4), 1409–1439. https://doi.org/10.1152/PHYSREV.00034.2006

Ibrahim, R., Kambal, A., Abdelmajeed, M. A., Ibrahim, R., Kambal, A., & Abdelmajeed, M. A. (2025). Glucagon-Like Peptide-1 Receptor Agonists in Neurodegenerative Diseases: A Comprehensive Review. Cureus, 17(9). https://doi.org/10.7759/CUREUS.92441

Kellar, D., & Craft, S. (2020). Brain insulin resistance in Alzheimer’s disease and related disorders: mechanisms and therapeutic approaches. The Lancet. Neurology, 19(9), 758–766. https://doi.org/10.1016/S1474-4422(20)30231-3

Meissner, W. G., Remy, P., Giordana, C., Maltête, D., Derkinderen, P., Houéto, J.-L., Anheim, M., Benatru, I., Boraud, T., Brefel-Courbon, C., Carrière, N., Catala, H., Charif, M., Colin, O., Corvol, J.-C., Damier, P., Dellapina, E., Devos, D., Drapier, S., … Rascol, O. (2024). Trial of Lixisenatide in Early Parkinson’s Disease. The New England Journal of Medicine, 390(13), 1176–1185. https://doi.org/10.1056/NEJMOA2312323

Michaelsen, M. K., Drasbek, K. R., Valentin, J. B., Svart, M., Larsen, J. B., Kruuse, C., Simonsen, C. Z., & Blauenfeldt, R. A. (2026). GLP-1 Receptor Agonists as Treatment of Nondiabetic Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke, 57(2). https://doi.org/10.1161/STROKEAHA.125.053075

Ros-Madrid, I., Cano-Mármol, R. P., Ferrer-Gomez, M., & Ramos-Molina, B. (2025). Anti-inflammatory properties of GLP-1 receptor agonists and other ancillary benefits from a pharmacological perspective. Canadian Journal of Physiology and Pharmacology, 103(12), 369–377. https://doi.org/10.1139/CJPP-2025-0148/ASSET/IMAGES/CJPP-2025-0148_TAB1.GIF

Roy, A., Dawson, V. L., & Dawson, T. M. (2025). From metabolism to mind: The expanding role of the GLP-1 receptor in neurotherapeutics. Neurotherapeutics, 22(5), e00712. https://doi.org/10.1016/J.NEUROT.2025.E00712

Sánchez-Garrido, M. A., Brandt, S. J., Clemmensen, C., Müller, T. D., DiMarchi, R. D., & Tschöp, M. H. (2017). GLP-1/glucagon receptor co-agonism for treatment of obesity. Diabetologia, 60(10), 1851. https://doi.org/10.1007/S00125-017-4354-8

Scheltens, P., Atri, A., Feldman, H. H., Zetterberg, H., Sano, M., Johannsen, P., León Colombo, T., Bardtrum, L., Jeppesen, R., Hansen, C. T., Cummings, J. L., Philip Scheltens, C., & Center, A. (2026). Baseline characteristics from evoke and evoke+: Two phase 3 randomized placebo‐controlled trials of semaglutide in participants with early‐stage symptomatic Alzheimer’s disease. Alzheimer’s & Dementia : Translational Research & Clinical Interventions, 12(1), e70200. https://doi.org/10.1002/TRC2.70200

Sun, M., Wang, X., Lu, Z., Yang, Y., Lv, S., Miao, M., Chen, W. M., Wu, S. Y., & Zhang, J. (2025). Evaluating GLP-1 receptor agonists versus metformin as first-line therapy for reducing dementia risk in type 2 diabetes. BMJ Open Diabetes Research & Care, 13(4), e004902. https://doi.org/10.1136/BMJDRC-2025-004902

Talbot, K. (2014). Brain insulin resistance in Alzheimer’s disease and its potential treatment with GLP-1 analogs. Neurodegenerative Disease Management, 4(1), 31. https://doi.org/10.2217/NMT.13.73

Tang, H., Donahoo, W. T., Dekosky, S. T., Lee, Y. A., Kotecha, P., Svensson, M., Bian, J., & Guo, J. (2025). GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related Dementias. JAMA Neurology, 82(5), 439–449. https://doi.org/10.1001/JAMANEUROL.2025.0353

Vijiaratnam, N., Girges, C., Auld, G., McComish, R., King, A., Skene, S. S., Hibbert, S., Wong, A., Melander, S., Gibson, R., Matthews, H., Dickson, J., Carroll, C., Patrick, A., Inches, J., Silverdale, M., Blackledge, B., Whiston, J., Hu, M., … Foltynie, T. (2025). Exenatide once a week versus placebo as a potential disease-modifying treatment for people with Parkinson’s disease in the UK: a phase 3, multicentre, double-blind, parallel-group, randomised, placebo-controlled trial. Lancet (London, England), 405(10479), 627–636. https://doi.org/10.1016/S0140-6736(24)02808-3

Wang, W., Wang, Q. Q., Qi, X., Gurney, M., Perry, G., Volkow, N. D., Davis, P. B., Kaelber, D. C., & Xu, R. (2024). Associations of semaglutide with first-time diagnosis of Alzheimer’s disease in patients with type 2 diabetes: Target trial emulation using nationwide real-world data in the US. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association, 20(12), 8661–8672. https://doi.org/10.1002/ALZ.14313

Yang, Y., Chen, L., Zhang, Y., Fu, W., Liu, D., & Jiang, T. (2025). Research on the effects of GLP-1 receptor agonists in treating cognitive dysfunction and gait disorders in elderly patients with diabetes. Frontiers in Pharmacology, 16, 1607443. https://doi.org/10.3389/FPHAR.2025.1607443

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Published

2026-09-23

How to Cite

Tekieli, B., Cyran , W. K., Matsiusheuskaya, . . T. ., Cionżyńska , W. ., Machnik, K. ., Gaweł, B. ., Justkowska-Gebauer , A. ., Olesiński , M. ., Chudyba , E., & Górecki , M. . (2026). GLP-1 AND DUAL GLP-1/GIP RECEPTOR AGONISTS AS NEUROPROTECTIVE AGENTS: MECHANISMS, CLINICAL EVIDENCE, AND TRANSLATIONAL PERSPECTIVES. International Journal of Innovative Technologies in Social Science, 4(3(51). https://doi.org/10.31435/ijitss.3(51).2026.6110

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