A brand new University College London study that includes 17,604 contributors age 45 and up found that semaglutide — a GLP-1 agonist present in weight-loss drugs like Ozempic and Wegovy — decreases the danger of main opposed cardiovascular occasions, like a heart attack and stroke, in sufferers who have been of a better weight or coping with weight problems. These sufferers additionally had heart problems, however did not have diabetes (the situation semaglutide is primarily used for), and early on within the examine, their MACE threat decreased no matter how a lot weight they misplaced or their waist circumference. Their outcomes have been in contrast with these of contributors taking a placebo.
After 20 weeks, a discount in waist measurement was related to a better discount in MACE in comparison with weight loss. Nonetheless, waist circumference alone accounted for, at most, 33% of the MACE discount, that means that semaglutide’s cardiovascular advantages weren’t solely primarily based on its influence on waist measurement.
This was the biggest examine of its type on GLP-1s in sufferers with heart problems, and it discovered that semaglutide might have cardiovascular advantages past its weight-loss results. Nonetheless, unwanted side effects of those medicine additionally should be thought of, which additional analysis can consider.
Within the meantime, we consulted with consultants to be taught extra about the advantages and dangers related to GLP-1s, similar to Ozempic, Wegovy and others.
What are GLP-1 agonists like Ozempic?
GLP-1 agonists, also referred to as incretin mimetics, are a category of remedy that’s primarily used to deal with sort 2 diabetes and, in some instances, weight problems.
“The glucagon-like peptide (GLP-1) is a naturally occurring hormone within the small gut which triggers the discharge of insulin from the pancreas. This course of helps to control blood sugar ranges,” mentioned Angela Haynes-Ferere, affiliate professor at Emory College of Nursing in Atlanta. “The GLP-1 agonist mimics the motion of this naturally occurring hormone. After consuming, blood sugars will rise, and these medicines trigger the pancreas to launch extra insulin which helps to decrease blood sugar.”
Along with serving to folks with sort 2 diabetes management their blood sugar, this remedy reduces one’s urge for food. It additionally slows the digestive course of so sufferers report feeling full with much less meals consumption. This leads to weight reduction for a lot of customers, however it varies primarily based on many individualized components, mentioned Haynes-Ferere.
Based on Cleveland Clinic, many of the GLP-1 agonists are available as liquid remedy that must be injected beneath the pores and skin, besides one that’s out there in pill type (Rybelsus).
A number of generic and brand names of GLP-1 agonists, based on the Johns Hopkins Affected person Information to Diabetes, embody:
- Dulaglutide, marketed as Trulicity
- Lixisenatide, marketed as Adlyxin
- Liraglutide, marketed as Victoza
- Semaglutide, marketed as Ozempic
- Semaglutide oral, marketed as Rybelsus
- Tirzepatide, marketed as Mounjaro or Zepbound (a twin GLP-1/GIP agonist)
Every model has its personal really useful dosage and frequency of consumption. Some could also be taken as soon as day by day, whereas others are used weekly. You will need to seek the advice of your physician to grasp what dosage and frequency greatest swimsuit you.
Potential GLP-1 agonist advantages
“Along with controlling blood sugar and decreasing weight problems, these medicines have been proven to scale back cardiovascular dangers and enhance kidney operate,” mentioned Haynes-Ferere. Anecdotally, people are reporting lowered smoking, playing, alcohol consumption and drug use, she famous.
“Research have proven advantages in worsening kidney illness, coronary heart failure and obstructive sleep apnea in sufferers with weight problems,” says Dr. Leon Jons, a weight administration specialist and scientific affiliate professor of Inside Medication-Endocrinology and Metabolism at Carver Faculty of Medication in Iowa.
Based on Cleveland Clinic, different benefits of GLP-1 agonists could embody:
- Decreasing blood strain
- Enhancing lipid problems
- Lowering systemic inflammation
- Delaying the development of diabetes-related nephropathy or diabetes-related kidney illness, aka DKD
These advantages not solely make GLP-1 agonists efficient for managing sort 2 diabetes but additionally contribute to higher cardiovascular well being. Nonetheless, the impact of GLP-1 agonists varies from one individual to a different. At all times discuss to your physician to grasp how GLP-1 agonists could profit your particular situation.
GLP-1 agonists might decrease blood strain, cut back irritation and enhance kidney operate.
GLP-1 agonist unwanted side effects and dangers to think about
For some sufferers, the velocity of weight reduction can result in the undesired beauty impact of a gaunt face (colloquially known as “Ozempic face”), notably in sufferers with much less pores and skin elasticity, mentioned Haynes-Ferere. She added that common train with weight coaching can assist protect muscle mass and preserve a wholesome look.
The medicines’ unwanted side effects are predominantly associated to the gastrointestinal system — for instance, nausea, constipation, diarrhea or belching. For many sufferers, these results are gentle and resolve over time. For some, the unwanted side effects may be extreme, and sufferers would want to cease the remedy, Jons mentioned.
Different widespread side effects of GLP-1 agonists, as reported in a Nationwide Library of Medication article, embody:
- Lack of urge for food
- Vomiting
- Headache
- Dizziness
- Delicate tachycardia (elevated coronary heart price)
In some instances, minor episodes of hypoglycemia could happen. “Hypoglycemia could be extraordinarily uncommon and is extra more likely to happen in sufferers who’re additionally taking different diabetes medicines that may decrease blood sugar an excessive amount of,” mentioned Dr. Troy Mensen, a household drugs physician primarily based within the Chicago space and member of the CNET medical evaluation board. Cleveland Clinic studies that hypoglycemia is a situation wherein blood glucose ranges drop below 70 mg/dL. If left untreated, it could change into life-threatening. Signs of hypoglycemia could embody shakiness, weak spot, nausea, problem concentrating and dizziness. Consuming sugars or carbohydrates can deal with hypoglycemia.
Additionally, docs don’t suggest GLP-1 agonists to pregnant folks since it could pose a risk to the growing fetus. Seek the advice of your physician when you’re pregnant, planning to get pregnant or are breastfeeding.
Who ought to take GLP-1 agonists?
Docs primarily suggest GLP-1 agonists for sort 2 diabetes and weight problems. Nonetheless, GLP-1 agonists aren’t the primary alternative of therapy. Metformin, an oral remedy, stays the first choice for managing sort 2 diabetes. Nonetheless, docs could suggest GLP-1 agonists when you:
- Can not tolerate metformin
- Are unable to decrease your blood sugar ranges with ongoing medicines even after three months
- Expertise problems because of different situations similar to coronary heart failure, atherosclerosis or persistent kidney illness
Cleveland Clinic studies that docs can also suggest two GLP-1 agonists, semaglutide and liraglutide, for treating weight problems. Dr. Mensen provides that tirzepatide (Mounjaro or Zepbound), a twin GLP-1/GIP agonist, can also be really useful.
“Primarily based on the truth that every particular person expertise with this remedy is totally different, the affected person ought to work with their healthcare supplier to find out the very best therapy plan and purpose for total well-being,” mentioned Haynes-Ferere.
Moreover, GLP-1 agonists similar to dulaglutide, semaglutide and liraglutide have been proven to offer cardiovascular advantages. Docs can also suggest these GLP-1 agonists to reduce the danger of coronary heart illness.
The really useful frequency of consumption for generally prescribed GLP-1 agonists contains:
- Dulaglutide: Weekly
- Liraglutide: Every day
- Semaglutide: Weekly
- Tirzepatide: Weekly
- Semaglutide tablets: Every day
Relying on which GLP-1 agonist you are taking, there’s a totally different really useful frequency.
Who mustn’t take GLP-1 agonists?
Though GLP-1 agonists can assist to successfully deal with sort 2 diabetes and weight problems, they is probably not appropriate for everybody. Your physician could avoid prescribing GLP-1 agonists when you’ve got:
- Household historical past of medullary thyroid most cancers: This uncommon thyroid most cancers has been linked to the usage of GLP-1 agonists in rodents. Your physician could keep away from prescribing GLP-1 agonists when you’ve got a household historical past of medullary thyroid most cancers.
- A number of endocrine neoplasia syndrome sort 2, or MEN2: A uncommon situation characterised by tumors in endocrine glands. Docs could keep away from prescribing GLP-1 agonists when you’ve got been identified with or have a household historical past of MEN2 since they will stimulate irregular cell development.
- Pregnant folks: Docs could not suggest GLP-1 agonists to pregnant folks since it might pose a threat to the growing fetus.
- Historical past of pancreatitis: Docs most frequently keep away from GLP-1 agonists in folks with a historical past of pancreatitis since GLP-1 agonists could improve the danger of deadly hemorrhagic and necrotizing pancreatitis.
- Inflammatory bowel problems or gastroparesis: GLP-1 agonists sluggish gastric emptying and will worsen signs of inflammatory bowel problems.
GLP-1 overdoses and essential data to recollect
GLP-1 agonists are prescription medicines and needs to be taken solely beneath the supervision of your physician. Following the really useful dosage can assist to forestall overdoses. Based on America’s Poison Facilities, an overdose of GLP-1 typically causes comparable signs to unwanted side effects:
- Nausea
- Diarrhea
- Vomiting
- Stomach ache
- Constipation
Nonetheless, the period of those signs could also be longer. In extreme instances, you may additionally expertise dehydration and hypoglycemia, which can require instant medical consideration.
You will need to double-check the dose earlier than taking the remedy and set a reminder for the following dose to forestall the danger of overdose.
In case you expertise any extreme unwanted side effects when taking a GLP-1 agonist, contact your physician instantly.
When to contact a physician if taking a GLP-1 agonist
You will need to contact your physician when you’re experiencing severe unwanted side effects after utilizing a GLP-1 agonist, similar to:
- Nausea
- Stomach ache
- Dizziness
- Improve in coronary heart price
- Shaking or trembling
Additionally, seek the advice of your physician first when you assume the remedy just isn’t working for you or when you’re contemplating not persevering with the remedy.
Moreover, scheduling common follow-ups along with your physician when you’re on GLP-1 agonists is essential. These follow-ups assist monitor your blood glucose ranges and decide if any dosage modifications are obligatory. Common follow-ups may also assist docs monitor indicators of hypoglycemia, renal illness, pancreatitis and thyroid most cancers.
The underside line
GLP-1 agonists are medicines that primarily deal with sort 2 diabetes and weight problems. Nonetheless, latest research recommend they will decrease blood strain, cut back irritation and enhance lipid problems. A number of manufacturers can be found, every having their very own dosage pointers. Nonetheless, GLP-1 agonists is probably not appropriate for everybody. You will need to discuss to your physician to grasp whether or not it’s best to take GLP-1 agonists in your situation.
