GLP-1 receptor agonists in diabetes-associated neurological disorders

Background/Objectives Diabetes is associated with complications in the central and peripheral nervous systems, including Parkinson’s disease, stroke, depression, epilepsy, diabetic peripheral neuropathy, and diabetic retinopathy. Evidence indicates that GLP-1 RAs may offer neuroprotective and systemic benefits beyond blood sugar regulation by affecting neuroinflammation, oxidative stress, mitochondrial issues, cell death, and synaptic plasticity. This review examines the effectiveness and potential of GLP-1 RAs in treating neurological comorbidities. Methods A thorough review of preclinical and clinical studies was performed to evaluate the impact of GLP-1 RAs on related neurological comorbidities. Results Preclinical studies show reduced loss of dopaminergic neurons, recovery of striatal dopamine levels, increased neurogenesis, and reduced oxidative stress and neuroinflammation. Clinical trials report improvements in motor and non-motor symptoms with exenatide and liraglutide. These drugs lower the risk of ischaemic stroke through vasoprotection, anti-inflammatory effects, and modulation of cardiovascular risk. Responses in psychiatric conditions vary. Epilepsy models demonstrate reduced seizure severity and cognitive deficits. In diabetic peripheral neuropathy, improvements include better nerve conduction, reduced neuroinflammation, and increased neuronal survival. In diabetic retinopathy, a slight increase in the incidence of related complications is noted. Conclusion GLP-1 RAs appear safe and suitable for neurological conditions associated with diabetes, except for retinopathy, and confirming their benefits will require improved strategies, comparative research, and further trials across diverse populations.