Semaglutide is a novel type of diabetic medication known as a GLP-1 agonist. The medication primarily operates on the gut and mimics the function of incretins, which are hormones generated when we ingest food. Incretins are in charge of controlling insulin and glucagon levels. The medication boosts insulin secretion, which is needed to digest glucose in the blood, while decreasing glucagon secretion, which is known to enhance glucose generation. The medication also decreases glucose accumulation in the liver.
For the treatment of Type 2 diabetes, semaglutide is offered as Ozempic (injectable) and Rybelsus (oral).
The medicine’s utilization of the incretin pathway also results in appetite reduction and feeling fuller with fewer servings. It is how you lose weight. Wegovy, a higher 2.4mg once-week injectable dosage, is available for weight loss.
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The medication has been observed to lower weight by 15% in overweight or obese people, with one-third of research participants losing up to 20% of their body weight. According to experts, this is exceptional; no weight-reduction treatment other than bariatric surgery may result in such significant weight loss.
Semaglutide’s Effect on Heart Health
It is not unexpected that the medication minimizes severe cardiovascular adverse events because it controls blood glucose levels and helps individuals lose weight (2). The most frequent risk factors for these heart diseases are obesity, diabetes, and hypertension.
The company Novo Nordisk revealed earlier this week that a trial in overweight or obese persons without diabetes found that the treatment lowered the risk of heart attacks, strokes, and other cardiovascular illnesses and linked fatalities by 20%. The experiment comprised 17,604 obese or overweight adults over the age of 45 who were given the higher dosage advised for weight loss.
Dr. VK Bahl, Max Hospitals’ primary director of cardiac science, stated that the company has demonstrated benefits to cardiac health not only in the dose suggested for Type 2 diabetes therapy but also in the higher amount advised for weight loss. “After diabetes drugs glitazones were discovered to increase the risk of heart failure nearly 20 years ago, regulatory authorities mandated that diabetes drugs would not be approved unless they were also beneficial to the heart,” he said.
Martin Holst Lange, executive vice president for Development at Novo Nordisk, in a release, said, “People living with obesity have an increased risk of cardiovascular disease but to date, there are no approved medications proven to deliver effective weight management while also reducing the risk of heart attack, stroke or cardiovascular death. Therefore, we are very excited about the results from SELECT showing that Semaglutide 2.4 mg reduces the risk of cardiovascular events.”
Semaglutide Usage Guidelines and Considerations
According to doctors, Semaglutide is the most beneficial for diabetics who are overweight or obese. However, the medication has also been licensed for weight loss on its own. The American Heart Association’s new guidelines, announced last month, also urge that the drug be used more widely by those who do not have diabetes.
However, doctors do not recommend using the medication in adults with normal BMI who want to lose a few pounds. Furthermore, they claim that people must continue to make lifestyle adjustments such as eating better and more frequently.
The injection must be administered once a week.
Dr. Rakesh Yadav, professor of cardiology at the All India Institute of Medical Sciences, said, “The GLP-1 agonists have shown good results in controlling diabetes and obesity over and above the conventional therapies. But these are incremental benefits.”
Cost Barrier Hinders Widespread Adoption of Treatment
When it comes to the adoption of the treatment, the most significant barrier is the expense. Although the weight-loss dosage has not yet been approved in India, it is accessible on request. It can range from Rs 12,000 to 20,000 per month. The cost may also be affected by availability, as the drug is currently in short supply in the United States.
Dr. Yadav said, “It can help overweight and obese people with diabetes. However, cost is a major issue. If a person can afford it, well and good. But if I ask my patients to spend thousands of rupees on a single medicine every month, they will go hungry and are more likely to have adverse outcomes.”
References:
- Lingvay I, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, Hardt-Lindberg S, Hovingh GK, Kahn SE, Kushner RF, Lincoff AM, Marso SP, Fries TM, Plutzky J, Ryan DH; SELECT Study Group. Semaglutide for cardiovascular event reduction in people with overweight or obesity: SELECT study baseline characteristics. Obesity (Silver Spring). 2023 Jan;31(1):111-122. doi: 10.1002/oby.23621. Epub 2022 Dec 10. PMID: 36502289; PMCID: PMC10107832.
- https:www.nejm.org/doi/full/10.1056/nejmoa1607141
Source: Medindia
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