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New diabetes guidelines for use of Ozempic and other GLP-1




New diabetes guidelines for use of Ozempic and other GLP-1


The American College of Physicians has issued new guidelines for the treatment of type 2 diabetes, recommending for the first time the use of GLP-1s and another class of diabetes drugs, called SGLT-2s, in addition to metformin, although this may exacerbate ongoing shortages of medications of various GLP medications can worsen. -1s.

Key facts

GLP-1s are medications designed to manage obesity and type 2 diabetes by interacting with the hunger part of the brain to suppress appetite and lower blood sugar and A1C, while SGLT-2s lower blood sugar levels by preventing the kidneys from reabsorbing the sugar produced by the body.

The ACP recommends treating type 2 diabetes with GLP-1 agonists to reduce the risk of all causes of death, major cardiovascular events, and stroke, and recommends the use of SGLT-2 to reduce the risk of all causes of death and major cardiovascular events to decrease. , progression of chronic kidney disease and hospitalization due to congestive heart failure, according to a new study published in the Annals of Internal Medicine.

In the updated guidelines, the ACP also recommends the use of DPP-4 inhibitors in addition to metformin, as new evidence shows that DPP-4s do not reduce disease or death.

The high cost of GLP-1s, which can cost up to around $1,070, and SGLT-2s – the most common SGLT-2 costs around $650— can be a “significant barrier” to providing patients with access to treatment, according to an accompanying editorial by Fatima Zyed, an internal medicine physician at Duke University’s Department of General Internal Medicine.

This is an update from the ACP states Guidelines 2017which recommended that doctors prescribe metformin to patients with type 2 diabetes, and recommended the use of other diabetes medications such as SGLT-2s and DPP-4s as secondary medications to help improve high blood sugar.

Will this affect the supply of Glp-1s?

There is already a shortage of some GLP-1 drugs due to high demand. While all doses of the diabetes drug Ozempic are available, all doses of Nordisk’s weight-loss drug Wegovy are in a shortage except the highest dose, 2.4 milligrams. Nordisk has not yet provided a timetable for when supply will improve. Nordisk told Forbes that it will gradually increase supply of all Wegovy doses over the rest of the year, and said in its annual report that it is considering ways to remove “bottlenecks” from the supply chain, for example by making disposable injection pens. According to the Food and Drug Administration (FDA) drug shortage report, all doses of Eli Lilly’s diabetes drug Mounjaro and the weight-loss drug Zepbound are in short supply until at least the end of June. Both contain the active substance tirzepatide. database. The 2.5 milligram doses are the lowest dosage Lilly offers, and often patients start taking the dose as soon as they are first prescribed the medication. Patients typically stay on at least one dose four weeks and then move on to the next highest dose, but for some this may not be an option if medications are still in short supply. Lily told NBC News plans to open a new production facility in North Carolina by the end of the year to help increase supply.

Large number

38.4 million. That’s the number of Americans who had diabetes in 2021, accounting for a total of 11.6% of the population. facts of the American Diabetes Association. Another 97.6 million people over the age of 18 had prediabetes.

Important background

Much research has been done on the effects of GLP-1s on diabetes and weight loss. During a 72-week trial, participants saw a “substantial and sustained reduction in body weight” by taking tirzepatide, regardless of drug dosage, a 2022 study found it. Participants who took semaglutide – the active ingredient in Ozempic and Wegovy – lost an average of 15% of their body fat, according to a 2021 study. study. German researchers found it semaglutide offered improvements in blood sugar levels and weight loss for type 2 diabetics after a six-month trial. Tirzepatide “robustly” improved blood sugar levels and helped with weight loss in patients with type 2 diabetes, according to research published in JAMA Network Open.

Read further

Wegovy: Here’s when the weight loss drug’s supply could improve this year (Forbes)

List Price of Ozempic and Other Drugs Would Rise: Here’s What That Means for Consumers (Forbes)

What to Know About Ozempic: The Diabetes Drug Becomes a Viral Weight-Loss Hit (Elon Musk Taps It) and Creates a Shortage (Forbes)

Diabetes Drug Mounjaro Expected to Be Approved Soon for Weight Loss: What You Need to Know and How It Compares to Similar Drugs (Forbes)

With the Zepbound shortage growing, Eli Lilly says there is no immediate end in sight (NBC News)