Beyond Glycemic Control: GLP-1RA–Based Therapies and Emerging Targets Beyond the Metabolic Axis

Background/Objectives. Modern diabetology is not only about reducing glycemia, it has a real impact on many other factors leading to the development of complications, deterioration of quality and shortening of life. GLP-1 receptor agonists fit perfectly into this model of diabetes therapy, which, apart from their excel-lent effect on the metabolic-renal-cardiac axis, also show many pleiotropic effects and innovative potential applications, which we described in this paper. Methods. The study presents an analysis of current literature data on the use of GLP-1RA, with particular emphasis on their pleiotropic effects. Results. GLP-1RAs have been shown to support the treatment of substance use disorders, including alcohol, cannabinoids, cocaine, and opioids. They are associated with improvements in mental health outcomes, including a reduction in de-pressive symptoms. GLP-1 RAs also demonstrate neuroprotective properties, including Alzheimer’s disease and Parkinson’s disease. While they are currently the most effective pharmacological agents for the treat-ment of obesity, they also significantly reduce hepatic steatosis and are associated with a decreased risk of developing hepatocellular carcinoma. Another promising area of investigation is their positive impact on the genitourinary system, including potential protective effects against prostate cancer, improvements in libido, beneficial effects in polycystic ovary syndrome (PCOS), and even enhancements in fertility. Additionally, this class of medications has been reported to exert favorable effects on pain associated with osteoarthritis and to reduce the frequency of obstructive sleep apnea episodes. Conclusions. Considering the overall sci-entific evidence presented, it is important to note that GLPs are no longer just antihyperglycemic drugs but are remarkably versatile, with a future in almost every field of medicine. GLP-1 RAs represent a break-through and the future of many new areas of activity, and their full potential has yet to be fully discovered.