GLP-1 Diabetes: Oxempic & Wegovy Info

Dr Jedha, Host

Hi there fantastic individuals, Dr Jedha right here and thanks a lot for becoming a member of me. At present, we’re exploring two drugs which have gained vital consideration: Ozempic and Wegovy.

It wouldn’t be far-fetched to say that medicine like Ozempic and Wegovy have taken the world by storm. With the promise of shedding vital quantities of weight, there was an explosion of individuals taking these medicine, to the extent that celebrities and others really brag about utilizing the treatment to realize their weight reduction success, which is simply loopy stuff. 

Earlier than we dive into this subject I wish to notice that I’m not sharing this info to scare anybody, for example, in the event you is likely to be taking the drugs we’re discussing on this episode at this time. The explanation I’m noting that is I do know some individuals can get offended by it. Offering information from analysis and the precise product brochures just isn’t designed to scare individuals, however to responsibly inform individuals. The proof is the proof and it’s the reality so in the event you’re not being knowledgeable by your physician, the place else would possibly you learn about it. It’s vital that you’ve got all the data to make knowledgeable choices and selections.

I’m at all times curious to learn the analysis surrounding these medicine and over the previous a number of months have bookmarked a number of papers that sparked curiosity. And some months again I used to be listening to an enchanting presentation by colleagues who spoke extensively about GLP-1 and these medicine. The knowledge I’m sharing at this time is the results of combining the analysis I’ve completed, with the issues realized from colleagues, together with info straight from the drug web sites and product labels. 

For our members, you’ll find all this info and extra info alongside episode 55 within the members library. For others, head to our web site for this episode and abbreviated info.

03:13

Let’s begin by understanding GLP-1. GLP-1 stands for Glucagon-Like Peptide-1. GLP-1 is a hormone that performs an important function in glucose metabolism. It’s a naturally-occurring hormone produced by our physique, within the intestines in response to food consumption. Certainly one of its main capabilities is to stimulate insulin secretion from the pancreas when blood sugar ranges are elevated, which helps to decrease blood sugar ranges.

Along with selling insulin secretion, GLP-1 suppresses the secretion of glucagon, one other hormone that raises blood sugar ranges. Glucagon is elevated in individuals with pre and T2Diabetes, so this twin motion of selling insulin secretion and suppressing glucagon is essential for sustaining glucose steadiness, for sustaining blood sugar steadiness. One other factor that GLP-1 does is it delays abdomen emptying, slowing down digestion, which helps cut back post-meal spikes in blood sugar. It additionally promotes satiety, or the sensation of fullness, which could be helpful for lowering cravings and for weight administration. Total, GLP-1 has an influence on each blood sugar management and urge for food regulation. And keep in mind, it’s a naturally-occurring hormone produced by our physique.

04:49

Now, let’s speak about Ozempic and Wegovy. Ozempic and Wegovy – semaglutide – are injectable prescription drugs made by the identical firm Novo Nordisk. These two drugs are designed to imitate the impact of GLP-1. Ozempic and Wegovy are referred to as GLP-1 receptor agonists. They bind to mobile receptors that GLP-1 would bind to, however otherwise, an elevated approach. Basically, they elevate the motion of GLP-1 in a approach the physique couldn’t obtain by itself, amplifying it to sure extremes, relying on dosage. Ozempic and Wegovy are injected drugs as a result of taking them in capsule kind just isn’t efficient; the digestive course of would break them down, lowering their efficacy. Injecting these drugs permits them to enter the bloodstream straight, making certain optimum absorption and motion within the physique.

When launched semaglutide was FDA accepted just for use as an anti-diabetic drug. We spoke about this manner again in episode 17 and 18, when Su Robotti, a unintended effects professional got here on the podcast as a visitor and spoke about her function on the FDA advisory committee once they accepted these medicine, it was a really fascinating dialogue. Level being, Ozempic was first accepted just for use as an anti-diabetic drug to decrease blood glucose. When the drug was first getting used as an anti-diabetic drug, it was famous that the drug had the advantage of lowering urge for food and meals consumption, and facilitating weight reduction. Quick ahead to now and the drug Wegovy, which is basically the identical drug as Ozempic, only a totally different model title, is now accepted as a weight reduction drug, resulting in a wild frenzy that’s now occurring throughout the globe. When Ozempic was being primarily used as an anti-diabetic drug, it was solely being prescribed in small modest dosages of the treatment, round 0.25mg as soon as per week. For that goal, these medicine may very well be warranted the place needed, as a result of at these decrease dosages, the advantages of the drug may outweigh potential unintended effects. Nevertheless, the surge in recognition for weight reduction has prompted a rise in dosages. At the moment, Ozempic could be prescribed as much as 2.0 mg weekly, whereas Wegovy has doses that go as much as 2.4 mg weekly. This escalation in dosage raises issues in regards to the long-term implications and potential unintended effects of upper doses getting used for weight reduction. Knowledge evaluating early prescribed dosages of Ozempic to present practices highlights this vital shift, as preliminary prescribing was extra conservative, centered on managing diabetes, whereas the present pattern leans closely in direction of weight administration at elevated doses.

As we coated earlier, these GLP-1 agonist medicine elevate the motion of GLP-1 – they suppress glucagon, which helps carry the blood sugar beneath management. And so they even have a direct impact on the fats cells, straight activating fats breakdown. All of that sounds nice, proper? Anybody desires to carry glucose down and spark fats loss. And by way of weight reduction, it is likely to be simple to get enthusiastic about shedding 5-20% of your physique weight, which is the common vary of weight discount proven in scientific trials. That might quantity to as much as 46 kilos or 20 kilos, as in some studies – that’s substantial by anybody’s phrases. However whereas the thought of a fast repair might sound interesting, there’s way more to think about, as we’ll get to a bit later. 

One other key profit usually promoted is that folks say they don’t get cravings anymore and that’s as a result of the drug reduces urge for food, it suppresses it. Once more, anybody of us might imagine, sure please, I wish to cut back the cravings I’ve that hit me each day at 5PM or 7PM when that sugar monster appears to be calling my title, wanting me to eat that sweet or chocolate cake, or crisps or crackers. Later we’ll contact upon why this isn’t a very good final result both. 

There was a current examine that checked out what components influenced the flexibility of individuals to realize a ten% of higher weight discount when taking semaglutide and these had been larger dosages of the drug, persistence with the treatment (those that remained on it for a yr or extra), and sufferers with a better BMI being handled. It is rather tough to remain on the treatment long run, and therein lies the large problem for a number of causes, which we’ll get to shortly as nicely. 

10:51

Reducing weight and lowering cravings and starvation could be highly effective motivators for eager to strive the drug. The opposite facet of the equation although, is there are the very actual potential penalties, and also you do must take these into consideration. With each treatment you’re taking there are unintended effects to think about. Docs and pharmaceutical firms might play these down, emphasizing the advantages, however the actuality is they may occur to you, they’ll’t assure they received’t.

Essentially the most notable concern made by the pharmaceutical firm is the potential of thyroid tumors, together with most cancers. The speed at which this may occasionally happen continues to be an unknown issue. 

One other warning is adjustments in imaginative and prescient. Research have proven semaglutide causes adjustments to imaginative and prescient, together with blurred imaginative and prescient, worsening of diabetic retinopathy and macular problems. Knowledge round this facet impact continues to be comparatively new, so it’s tough to conclude how extreme signs might develop into, though some research counsel a probably larger danger of blindness. 

Different potential unintended effects famous on the product label and clearly on the drug web sites, are irritation of your pancreas (pancreatitis) – we’ve had acute pancreatitis requiring hospitalization, happen in a few our members), gallbladder issues (together with gallstones which will want surgical elimination), kidney issues and kidney failure, severe allergic reactions, elevated coronary heart price, and melancholy or ideas of suicide. 

These are all fairly severe unintended effects to think about, ought to they have an effect on you. 

The commonest unintended effects reported by the pharmaceutical firm on their web site are and I quote, “nausea, diarrhea, vomiting, constipation, abdomen (stomach) ache, headache, tiredness (fatigue), upset abdomen, dizziness, feeling bloated, belching, low blood sugar in individuals with kind 2 diabetes, fuel, abdomen flu, heartburn, and runny nostril or sore throat.” Once more, a reasonably lengthy listing. 

Definitely we all know from the scientific literature that whe most typical unintended effects are gastrointestinal problems. In actual fact, research have reported there are 45 totally different gastrointestinal unintended effects, the commonest being nausea, diarrhea, vomiting, and belly ache, together with others not famous on the product label, corresponding to dry mouth, irregular gastrointestinal sounds, irregularity in bowel actions, and feces being discolored. Research have proven that every one dosages enhance gastrointestinal unintended effects, which may fluctuate in severity, and vary within the size of time individuals expertise them. 

14:16

Coming again to the truth that efficacy of the drug depends on an individual taking it for no less than a yr. Many individuals received’t tolerate the gastrointestinal unintended effects alone. In actual fact, we’ve had members hospitalized from dehydration associated to struggling the gastrointestinal unintended effects of semaglutide – these items actually do occur individuals, these items just isn’t a white elephant that occurs on the odd event.  Whereas it might be potential to realize a yr on the drug, revealed studies have indicated that inside two years of beginning the drug, round 70% of individuals select to get off the drug as a result of they’re feeling extremely sick on the drug and so they don’t wish to take it anymore. And that’s a giant, large problem.

While you cease taking these medicine, you’ll achieve all the burden again, and sure extra. It’s a must to keep on the drug for all times with the intention to keep the burden loss, and at this early level of the medicine widespread existence we don’t even know if that’s potential or what the long term results shall be. We additionally know long term consumption of those medicine is just not potential for many individuals, as indicated by the truth that a big majority of individuals voluntarily wish to cease taking the drug inside two years. 

There’s one different main downfall, analysis has proven that 20-40% of the burden misplaced is weight misplaced from lean mass, which implies you’re not shedding fats however you’re shedding muscle mass. That’s not good, particularly as we become older. Muscle mass is important for sustaining total well being and bodily operate because it helps mobility, steadiness, and power, that are essential for each day actions. Moreover, having satisfactory muscle mass contributes to metabolic well being by enhancing insulin sensitivity and aiding in weight administration. After age 40, muscle mass can begin to decline extra noticeably. By age 60, now we have an excellent more durable time sustaining muscle and bone mass, and restoring it may be much more tough, significantly for ladies with menopause and adjustments that happen in hormones that have an effect on muscle and bone mass. 

Let’s simply say you select to take the drug for weight reduction and inside a few years you resolve to cease taking the drug. You’ll achieve again weight and also you’ll rapidly achieve again fats however you received’t achieve your lean mass again. That muscle or bone loss could be everlasting, if not extremely tough to revive. So one of many key downfalls is that on the opposite facet, you’ll now really be fatter than earlier than. You would possibly nonetheless weigh the identical, however you’ll have extra fats mass and fewer lean mass. That’s not good as it will probably have an effect on power, mobility, and total well being, to not point out enhance insulin resistance and urge for food and starvation, seemingly greater than skilled earlier than. 

Coming again to these cravings we talked about earlier. Urge for food and cravings are dramatically decreased as a result of the drug influences the intestine, the intestines, slowing down the motion of the intestines. In response to consuming meals, our intestines have a pure contraction course of that strikes the whole lot from our abdomen alongside the intestines for absorption and processing and thru to our bowel for excretion. These medicine decelerate the pure motion and contraction of the intestines. Meals can keep within the digestive system quite a bit longer than it ought to. Belching and foul breath can develop into an issue, as meals ferments within the abdomen. One thing else to think about is that as a result of slower intestinal operate, digestive operate and diet absorption can develop into compromised and this may result in nutrient deficiency over time. 

Greater than that, it’s potential {that a} full paralysis of the intestines can happen attributable to these medicine. This situation is named ileus and is probably deadly. Ileus has occurred in individuals taking these semaglutide medicine and has led to about 20 deaths the final report I noticed. However intestinal paralysis has been seen in scientific observe amongst colleagues, so it’s actually a really actual consequence of those medicine. Ileus can probably result in everlasting paralysis of the intestines, with the necessity for tubes and baggage to deal with digestive processes. That doesn’t sound like a enjoyable final result for anybody, wouldn’t you agree?

Yet one more downfall is that though cravings is likely to be decreased initially, this impact wears off across the two yr mark, the place you will note your cravings and urge for food growing as soon as once more, so it’s worthwhile to up the dosage of the drug, which is probably going not potential for many as dosages will already be so excessive.

20:23 

What’s fascinating is there have been many papers being launched about the advantages of those medicine for all kinds of issues from enhancing coronary heart illness, cognitive operate to lowering danger of sure cancers, and Alzheimer’s illness. There are plenty of issues popping out round this, and so early of the drug being launched, it appears relatively astonishing. 

Definitely, it’s true that these studies have examined optimistic advantages and so they positive are hailing these advantages far and large, little doubt to attempt to outweigh the negatives. In actuality, colleagues have famous that the extra seemingly consequence of those advantages is as a result of the drug is lowering insulin resistance and enhancing insulin sensitivity all through the physique’s cells. Insulin resistance is on the middle of many continual well being situations and if we tackle the insulin resistance, we cut back the danger of coronary heart illness, stroke, Alzheimers, most cancers and the listing goes on. As we coated in episode 26 on insulin resistance, we will additionally enhance this with diet. 

21:31

In any case, what we’ve coated right here is that the quick time period advantages might look good, however the long run penalties, based mostly on the proof, the long run metabolic penalties, don’t appear definitely worth the dangers. 

Is it actually potential to maintain taking a drug ceaselessly? If not, which seems to be the case for a lot of, then you definately’re not simply again at sq. one, however sq. minus 10, as you’ll be left with extra fats mass and fewer lean mass, and once more, you’ll have to take a look at different choices. You’ll be left to take a look at choices you would have probably used within the first place – specifically, specializing in diet. 

By far, the healthiest, most sustainable strategy to drop some weight long run is thru diet and dietary adjustments, coupled with altering some issues in our life-style. In the event you’ve listened to the podcast a when you’ve heard of Wilma’s 79 pound weight reduction, that’s 36 kilos. Head to our testimonials web page to view tons of of testimonials from our members with their blood sugar and weight reduction success. Carin, shedding 15 kilos in just a few months, Suan 24 kilos, Lyn 44 kilos, Cheryl 21 kilos, and the listing goes on. And most inform us they’re so proud of the burden loss as a result of they’ve tried to drop some weight for years and by no means may. We can assist you drop some weight, naturally, so please head right down to our web site and be part of us as a member. It’s tough to do it by yourself. You want the precise pointers, the precise instruments and the continued help to realize it, that’s what’s helped all our members get higher outcomes than they’ve ever had.  Simply head to our web site to view the testimonials and please be part of us – you don’t should do it alone! 

Once more, I wish to emphasize that I’ve shared this info at this time to tell you about potential penalties of those semaglutide drugs. In the event you’re already taking these medicine, chances are you’ll want to take into account working along with your physician to cut back them over time, at the side of working in your diet with a program such because the T2Diet Program or becoming a member of us as a member. In the event you’re not but taking them however have been contemplating the choice, maybe now chances are you’ll rethink the long term outcomes and pursue a distinct possibility, focusing in your diet. Both approach, I hope you might have discovered this episode informative and useful. 

In the event you do have additional questions or enter, head to our web site. Feedback are at all times open on our weblog the place we publish these episodes and you can even submit questions through voice message or e mail. 

That’s all for now. Care for you. 

Dr Jedha, over and out.