Which of the following is a GLP-1 receptor agonist?

• A. Pramlintide
• B. Metformin
• C. Canagliflozin
• D. Exenatide

Answer: (D)

GLP-1 receptor agonists are drugs that mimic the incretin hormone GLP-1, triggering glucose-dependent insulin secretion, suppressing glucagon when blood sugar is high, and often slowing gastric emptying to reduce post-meal glucose spikes. Exenatide is a synthetic peptide that directly binds and activates GLP-1 receptors, so it acts like GLP-1 and helps increase insulin release in response to meals while also helping to lower postprandial glucose.

The other medications listed work by different mechanisms. Pramlintide is an amylin analog that slows gastric emptying and helps regulate appetite and post-meal glucose, but it does not act on GLP-1 receptors. Metformin reduces hepatic glucose production and improves insulin sensitivity, not through GLP-1 receptor pathways. Canagliflozin inhibits SGLT2 in the kidneys, promoting urinary glucose excretion rather than modulating GLP-1 signaling.

So, the drug that fits the GLP-1 receptor agonist class is exenatide.