A study called SURMOUNT-1 https://investor.lilly.com/news-releases/news-release-details/tirzepatide-reduced-risk-developing-type-2-diabetes-94-adults evaluated weekly injections of tirzepatide currently approved for the treatment of diabetes and also for weight loss. The study evaluated over 1,000 pre-diabetic patients who were monitored for over 3 years. The study results showed that tirzepatide reduced the risk of prediabetes progressing to frank diabetes by 94% when participants taking the medication were compared with those given a placebo for the study. Weekly injections of the three approved doses, 5mg, 10mg and 15mg were used in the study.Those taking tirzepatide showed sustained weight loss during the three year treatment period. Those who received the higher of the three different doses of the medication lost 23 % of their body weight. https://pmlive.com/pharma_news/eli-lillys-gip-glp-1-receptor-agonist-tirzepatide-shown-to-significantly-reduce-type-2-diabetes-risk/
Tirzepatide works by targeting two hormones whose activity is related to appetite and fat deposition- glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The weekly injections control blood sugar levels and also diminish food cravings. This study attempted to prove what actually seems logical if not obvious- that when people who are at a high risk for developing diabetes take this medication, they not only achieve better control their blood sugar but they avoid the progression from prediabetes to actual diabetes, which is diagnosed when the borderline blood glucose levels characteristic of prediabetes are further elevated, meeting the criteria for the diagnosis of diabetes. Michael Weintraub, MD a clinical associate professor of endocrinology at NYU Langone Health says, “We don’t have any medication approved to treat prediabetes right now. If we can intervene earlier and treat the underlying obesity before it leads to Type 2 diabetes or other complications, then that’s going to reduce the overall risk of the No. 1 killer of individuals with obesity, which is cardiovascular disease.” https://time.com/7017001/tirzepatide-zepbound-weight-loss-drug-diabetes/
Approximately one in three people in this country has prediabetes according to the U.S. Centers for Disease Control and Prevention. Many if not most of these people are not even aware of their condition because they may not have any associated symptoms. It is estimated that 5-10 % of people with prediabetes will progress to diabetes each year. The risk of developing diabetes is greatest for those who are obese or overweight. Overreating and inactivity can exacerbate insulin resistance. Jeff Emmick, of the Eili Lilly company says, “Obesity is a chronic disease that puts nearly 900 million adults worldwide at an increased risk of other complications such as Type 2 Diabetes…. This data reinforces the potential clinical benefits of long-term therapy for people living with obesity and pre-diabetes.” This study evaluated this high risk population of prediabetics in an attempt to quantify the help such people might receive from taking tirzepatide to avoid progression from prediabetes to diabetes.
The findings build on previous results released in 2022 in the New England Journal of Medicine in the same population after a one-year follow-up that focused mostly on weight loss. But the longer time period of the current study allowed doctors to track patients’ prediabetes and progression to diabetes.
Dr Weintraub explains that tirzepatide may be helping to reduce the likelihood of developing diabetes in several ways: controlling weight, increasing insulin production to control blood sugar, and addressing inflammation, all of which can lead to insulin resistance. Also, of importance was the observation that when patients discontinued tirzepatide and were evaluated after 4 months they began to regain some of their weight loss and diabetes related parameters worsened.
GLP-1 Weight Loss Medications Have Other Medical Benefits
Preventing Diabetes Lowers the Risk of Other Diseases
Diabetes itself is a worrisome condition to develop because there are many other serious health problems associated with diabetes.
Diabetics have an increased risk of:
- Cardiovascular Disease – heart attack, stroke and cardiac deaths. A study published in the prestigious New England Journal of Medicine has found that the GLP-1 weight loss drug semaglutide reduced the risk of cardiac death by 20%.
- Kidney problems – the leading cause of needing dialysis treatment for kidney failure is having diabetes.
- Nerve damage – diabetic neuropathy is a painful condition most commonly affecting the legs and feet- there is no cure , and medications are often not very effective.
- Gum disease – Excess sugar in the bloodstream causes too much sugar in saliva which promotes gum and dental disease.
- Cancer – It is estimated that 4-8% of all cancers are obesity related. Obesity is a risk factor for many types of cancer including breast, uterine, kidney, gallbladder, liver and pancreatic cancers as well as colorectal cancer.
- Sexual dysfunction in both men and women.
PCOS
Polycystic Ovarian Syndrome (PCOS) is characterized by menstrual cycle irregularity, weight gain, fertility problems, excessive hair growth, and acne. There are also metabolic factors involved in PCOS such as insulin resistance, with its associated risk of pre-diabetes and diabetes. And these conditions impart a greater risk of cardiovascular disease. Because insulin resistance is involved in this disorder, it makes sense that Tirzepatide) might help PCOS. In patients with PCOS weight loss improves menstrual irregularities, restores ovulation, and improves fertility. Since Tirzepatide is not currently FDA approved for PCOS its current use in PCOS is considered an off-label use of the medication. But many leading gynecologists around the US are indeed prescribing it for PCOS patients. Florencia Haperin,MD says, “because these medications cause significant weight loss and improve insulin resistance, it makes sense biologically, that they would be helpful for women with PCOS.”
HELP WITH ALCOHOL ADDICTION
Success for weight loss is due to actions which reduce the desire for food. This was first noticed when doctor’s prescribing these weight loss drugs were made aware by their patients that along with less desire for food, they found it easy to pass up their consumption of alcohol, which they were advised to do as a part of their weight loss plan. Yet another striking effect that has been reported is that these medications also decrease the desire for nicotine and opioids!
