These benefits have been demonstrated in large, well-designed cardiovascular outcome trials, including: Liraglutide (Victoza) the LEADER trial , which showed a significant reduction in cardiovascular death and all-cause mortality Semaglutide (Ozempic) the SUSTAIN-6 trial , demonstrating fewer major adverse cardiovascular events, particularly stroke Dulaglutide (Trulicity) the REWIND trial , which showed a significant reduction in major cardiovascular events even in people without established cardiovascular disease Tirzepatide (Mounjaro) cardiovascular outcome data from the SURPASS-CVOT programme are emerging, with early results suggesting cardiovascular benefit compared with insulin therapy These cardiovascular effects are a key reason why GLP-1based therapies are now recommended earlier in the treatment pathway for people with type 2 diabetes who have established heart disease or are at high cardiovascular risk

When GLP-1 medications slow gastrointestinal transit, fermentable carbohydrates remain exposed to gut microbes longer, increasing gas and bloating in susceptible individuals

Trulicity (dulaglutide) demonstrates superiority in reduction of cardiovascular events for broad range of people with type 2 diabetes Lilly 05nov2018: Initial results from EMPRISE real-world evidence study show Jardiance was associated with reduced risk for hospitalization for heart failure compared with DPP-4 inhibitors in people with type 2 diabetes with and without cardiovascular disease Novo 26oct2018: Oral semaglutide demonstrates statistically significant reductions in HbA1c and body weight in people with long duration of type 2 diabetes treated with insulin [ PIONEER 8 ] Lilly 2018oct04: Lilly's Investigational Dual GIP and GLP-1 Receptor Agonist Shows Significant Reduction in HbA1c and Body Weight in People With Type 2 Diabetes Novo 2018oct02: People with diabetes may achieve improved glycaemic control with Tresiba versus glargine U100, without an increase in hypoglycaemia Lilly 2018sep26: Chugai and Lilly Enter into a License Agreement for Oral GLP-1 Agonist, OWL833 FDA: FDA warns of serious genital infection linked to certain diabetes drugs Novo 2018aug20: Oral semaglutide provides superior HbA1c and weight reductions versus placebo in people with type 2 diabetes and renal impairment in the PIONEER 5 trial Novo 2018aug17: Novo Nordisk acquires Ziylo Ltd to accelerate its development of glucose responsive insulins [/expand] Both companies are seeing growth in the US in their GLP1 receptor agonist class of drugs

Clinical studies show specific probiotic strains like Lactobacillus acidophilus and Bifidobacterium lactis can reduce these symptoms by 35-40% when taken alongside GLP-1 medications, helping restore gut microbiome balance disrupted by delayed gastric emptying
Shaman AM, Bain SC, Bakris GL, Buse JB, Idorn T, Mahaffey KW, et al