{"id":4789,"date":"2026-06-15T18:28:20","date_gmt":"2026-06-15T18:28:20","guid":{"rendered":"https:\/\/academicsolidarity.com\/?p=4789"},"modified":"2026-06-15T18:28:21","modified_gmt":"2026-06-15T18:28:21","slug":"glp-1-agonistleri-metabolik-tipta-yeni-bir-cag-mi","status":"publish","type":"post","link":"https:\/\/academicsolidarity.com\/?p=4789&lang=tr","title":{"rendered":"GLP-1 Agonistleri Metabolik T\u0131pta Yeni Bir \u00c7a\u011f m\u0131?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><em>GLP-1 agonistleri t\u0131pta yeni bir d\u00f6nemi temsil ediyor. Ancak en do\u011fru kullan\u0131m, heyecan ile ihtiyat\u0131n dengelendi\u011fi, ya\u015fam tarz\u0131 de\u011fi\u015fikliklerinin unutulmad\u0131\u011f\u0131, hasta g\u00fcvenli\u011fi ve toplumsal adaletin birlikte d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fc bir yakla\u015f\u0131mla m\u00fcmk\u00fcn olacakt\u0131r.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Son y\u0131llarda t\u0131pta belki de en h\u0131zl\u0131 y\u00fckselen ila\u00e7 gruplar\u0131ndan biri GLP-1 resept\u00f6r agonistleri oldu. Ba\u015flang\u0131\u00e7ta tip 2 diyabet tedavisi i\u00e7in geli\u015ftirilen bu ila\u00e7lar, bug\u00fcn \u015fi\u015fmanl\u0131k tedavisinin de merkezine yerle\u015fmi\u015f durumda. Exenatidin 2005\u2019te kullan\u0131ma girmesinden sonra liraglutid, dulaglutid ve semaglutid gibi molek\u00fcller geldi; daha sonra tirzepatid gibi GLP-1 etkisine GIP etkisini de ekleyen ila\u00e7lar tabloyu daha da de\u011fi\u015ftirdi. Eskiden kilo vermek i\u00e7in \u00e7o\u011funlukla diyet, egzersiz, davran\u0131\u015f de\u011fi\u015fikli\u011fi ve baz\u0131 s\u0131n\u0131rl\u0131 etkili ila\u00e7lardan s\u00f6z ederken, bug\u00fcn y\u00fczde 15\u201320 d\u00fczeyinde kilo kayb\u0131n\u0131 m\u00fcmk\u00fcn k\u0131lan farmakolojik se\u00e7eneklerden bahsediyoruz (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572151\/\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572151\/<\/a>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu ila\u00e7lar\u0131n temel etkisi, ba\u011f\u0131rsaktan salg\u0131lanan GLP-1 hormonunu taklit etmeleri. GLP-1, ins\u00fclin salg\u0131s\u0131n\u0131 art\u0131r\u0131r, glukagonu bask\u0131lar, mide bo\u015falmas\u0131n\u0131 yava\u015flat\u0131r ve beyinde tokluk hissini g\u00fc\u00e7lendirir. Bu nedenle hem kan \u015fekeri kontrol\u00fcnde hem de i\u015ftah\u0131n azalmas\u0131nda etkili olurlar. Tip 2 diyabette GLP-1 agonistleri HbA1c d\u00fczeyini anlaml\u0131 \u015fekilde d\u00fc\u015f\u00fcrmekte ve kilo kayb\u0131na yol a\u00e7maktad\u0131r. Ayr\u0131ca semaglutid ile yap\u0131lan kardiyovask\u00fcler ara\u015ft\u0131rmalarda, y\u00fcksek riskli diyabet hastalar\u0131nda kalp-damar olaylar\u0131n\u0131n azald\u0131\u011f\u0131 da g\u00f6sterilmi\u015ftir (<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1607141\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1607141<\/a>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Obezite alan\u0131ndaki veriler daha da dikkat \u00e7ekici. STEP-1 \u00e7al\u0131\u015fmas\u0131nda haftal\u0131k semaglutid 2,4 mg kullanan \u015fi\u015fman veya kilolu eri\u015fkinlerde 68 hafta sonunda ortalama kilo kayb\u0131 %14,9 iken, plasebo grubunda bu oran %2,4\u2019te kalm\u0131\u015ft\u0131r (<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2032183\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2032183<\/a>). Tirzepatid ile yap\u0131lan SURMOUNT-1 \u00e7al\u0131\u015fmas\u0131nda ise doza g\u00f6re yakla\u015f\u0131k %16 ile %22,5 aras\u0131nda kilo kayb\u0131 bildirilmi\u015ftir (<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35658024\/\">https:\/\/pubmed.ncbi.nlm.nih.gov\/35658024\/<\/a>). Kilo kayb\u0131, kan bas\u0131nc\u0131, ya\u011fl\u0131 karaci\u011fer, uyku apnesi, eklem y\u00fck\u00fc ve kardiyometabolik risk \u00fczerinde de olumlu etkiler yaratmaktad\u0131r. SELECT \u00e7al\u0131\u015fmas\u0131, diyabeti olmayan ancak \u015fi\u015fmanl\u0131k\/fazla kilo ve yerle\u015fik kardiyovask\u00fcler hastal\u0131\u011f\u0131 olan ki\u015filerde semaglutidin maj\u00f6r kalp-damar olaylar\u0131n\u0131 azaltt\u0131\u011f\u0131n\u0131 g\u00f6stererek bu alan\u0131 daha da geni\u015fletmi\u015ftir (<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1607141\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1607141<\/a>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu ila\u00e7lar\u0131n etkilerinin metabolizmayla s\u0131n\u0131rl\u0131 kalmayabilece\u011fine dair erken bulgular da var. Ba\u011f\u0131ml\u0131l\u0131k, ya\u011fl\u0131 karaci\u011fer, polikistik over sendromu, Alzheimer hastal\u0131\u011f\u0131 ve depresyon gibi alanlarda ara\u015ft\u0131rmalar s\u00fcrmekte. Yak\u0131n zamanda yay\u0131mlanan bir hayvan \u00e7al\u0131\u015fmas\u0131nda liraglutidin depresif davran\u0131\u015flar\u0131 ba\u011f\u0131rsak mikrobiyotas\u0131n\u0131 de\u011fi\u015ftirerek, \u00f6zellikle Laktobasillus delbrueckii art\u0131\u015f\u0131 ve endokannabinoid sistem \u00fczerinden hafifletti\u011fi \u00f6ne s\u00fcr\u00fcld\u00fc (<a href=\"https:\/\/www.eurekalert.org\/news-releases\/1130817\">https:\/\/www.eurekalert.org\/news-releases\/1130817<\/a>). Bu bulgu heyecan verici olmakla birlikte, hen\u00fcz insanlarda depresyon tedavisi anlam\u0131na gelmiyor. Yine de ba\u011f\u0131rsak-beyin ekseninin ne kadar \u00f6nemli olabilece\u011fini g\u00f6stermesi bak\u0131m\u0131ndan dikkate de\u011fer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Elbette bu ila\u00e7lar\u0131 \u201cmucize\u201d olarak sunmak do\u011fru de\u011fil. \u00c7o\u011fu ila\u00e7 gibi bunlar\u0131n da yan etkileri var. En s\u0131k yan etkiler aras\u0131nda bulant\u0131, kusma, ishal, kab\u0131zl\u0131k ve kar\u0131n a\u011fr\u0131s\u0131 bulunuyor. Daha nadir fakat \u00f6nemli riskler aras\u0131nda ise pankreatit, safra kesesi hastal\u0131klar\u0131, s\u0131v\u0131 kayb\u0131na ba\u011fl\u0131 b\u00f6brek sorunlar\u0131, kalp h\u0131z\u0131nda art\u0131\u015f ve baz\u0131 hastalarda diyabetik retinopatide k\u00f6t\u00fcle\u015fme say\u0131labilir (<a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2026\/215256s033lbl.pdf\">https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2026\/215256s033lbl.pdf<\/a>). \u0130ns\u00fclin veya s\u00fclfonil\u00fcre ile birlikte kullan\u0131ld\u0131\u011f\u0131nda hipoglisemi riski artabilir. Ayr\u0131ca med\u00fcller tiroid kanseri veya MEN2 \u00f6yk\u00fcs\u00fc olanlarda kullan\u0131lmamal\u0131d\u0131r. Psikiyatrik yan etkiler konusunda uzun s\u00fcre tart\u0131\u015fmalar olmu\u015f, ancak FDA\u2019n\u0131n son de\u011ferlendirmeleri, GLP-1 agonistlerinin intihar d\u00fc\u015f\u00fcncesine neden oldu\u011funa dair kan\u0131t bulamam\u0131\u015ft\u0131r (<a href=\"https:\/\/www.fda.gov\/drugs\/drug-safety-communications\/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type\">https:\/\/www.fda.gov\/drugs\/drug-safety-communications\/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type<\/a>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bir ba\u015fka sorun da eri\u015fim ve adalet. Bu ila\u00e7lara talep o kadar artt\u0131 ki, bir\u00e7ok \u00fclkede d\u00f6nem d\u00f6nem ila\u00e7 k\u0131tl\u0131\u011f\u0131 ya\u015fanmakta, diyabet hastalar\u0131n\u0131n ilaca eri\u015fimi zorla\u015fmaktad\u0131r. Bu durum, t\u0131bb\u0131n klasik sorusunu yeniden kar\u015f\u0131m\u0131za \u00e7\u0131kar\u0131yor: Bir tedavi etkili oldu\u011funda, ona kim, ne kadar ve hangi gerek\u00e7eyle ula\u015fabilmelidir? (<a href=\"https:\/\/www.ema.europa.eu\/en\/news\/eu-actions-tackle-shortages-glp-1-receptor-agonists\">https:\/\/www.ema.europa.eu\/en\/news\/eu-actions-tackle-shortages-glp-1-receptor-agonists<\/a>)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">GLP-1 agonistleri t\u0131pta yeni bir d\u00f6nemi temsil ediyor. Diyabet ve obezite tedavisinde g\u00fc\u00e7l\u00fc ara\u00e7lar sunduklar\u0131 a\u00e7\u0131k. Ancak en do\u011fru kullan\u0131m, heyecan ile ihtiyat\u0131n dengelendi\u011fi, ya\u015fam tarz\u0131 de\u011fi\u015fikliklerinin unutulmad\u0131\u011f\u0131, hasta g\u00fcvenli\u011fi ve toplumsal adaletin birlikte d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fc bir yakla\u015f\u0131mla m\u00fcmk\u00fcn olacakt\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>GLP-1 agonistleri t\u0131pta yeni bir d\u00f6nemi temsil ediyor. Ancak en do\u011fru kullan\u0131m, heyecan ile ihtiyat\u0131n dengelendi\u011fi, ya\u015fam tarz\u0131 de\u011fi\u015fikliklerinin unutulmad\u0131\u011f\u0131, hasta g\u00fcvenli\u011fi ve toplumsal adaletin birlikte d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fc bir yakla\u015f\u0131mla m\u00fcmk\u00fcn olacakt\u0131r. Son y\u0131llarda t\u0131pta belki de en h\u0131zl\u0131 y\u00fckselen ila\u00e7 gruplar\u0131ndan biri GLP-1 resept\u00f6r agonistleri oldu. Ba\u015flang\u0131\u00e7ta tip 2 diyabet tedavisi i\u00e7in geli\u015ftirilen bu ila\u00e7lar, [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4785,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[114],"tags":[],"class_list":["post-4789","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guncel"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/academicsolidarity.com\/wp-content\/uploads\/2026\/06\/20260614GLP1.png?fit=1448%2C1086&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/posts\/4789","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4789"}],"version-history":[{"count":1,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/posts\/4789\/revisions"}],"predecessor-version":[{"id":4790,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/posts\/4789\/revisions\/4790"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=\/wp\/v2\/media\/4785"}],"wp:attachment":[{"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4789"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4789"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/academicsolidarity.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4789"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}