6 Keys to the New Injectable to Treat Obesity and Diabetes

Tirzepatide, an injectable molecule presented as an innovative and superior option to the already disruptive alternatives for treating diabetes, obesity and overweight; He gave his talk last week and highlighted his differences: act on two receptors (In addition to affecting the feeling of satiety, it also affects fatty tissue.)

In a context in which the obesity Two weeks after the World Health Organization (WHO) published global guidelines for the use of GLP-1 receptor agonists for treatment, it is considered one of the most serious public health problems worldwide. A new dual-action option is now available in our country that promises results comparable to those of bariatric surgery.

Let’s recap: the already innovative options on the market (Ozempic – indicated for diabetes – and Wegovy – against obesity and overweight – whose drug is semaglutide; and the respective local versions Dutide and Obetide, based on the same drug) act similarly to a hormone secreted in the intestine in response to food intake: Glucagon type 1 (GLP-1).

But besides activating the GLP-1 receptor, the novelty of tirzepatide (whose trade name is Mounjaro and is available in prefilled pens) is that it acts and behaves dual GIP receptor agonist (glucose-dependent insulinotropic peptide).

Therefore, there is not only a reduction in food intake – as gastric emptying is slowed and insulin secretion is increased – but also changes in the gastrointestinal tract Metabolism of adipose tissue and at the level of energy efficiency.

“A person with obesity has a major disruption in what happens to the fat tissue, and the GIP acts as Warehouse manager “It corresponds to the energy we consume,” said cardiologist Jorge Tartaglione, former president of the Argentine Cardiological Foundation, in a colloquial way in which he explains to his patients – as he said in the official presentation to the media – how this molecule works.

This medication is intended for patients with obesity (body mass index – BMI – over 30), “insufficiently controlled” type 2 diabetes and/or overweight (BMI of 27 or more) with a comorbidity (such as high blood pressure, high cholesterol, heart disease, prediabetes or sleep apnea).

In contrast to nominations such as “the miracle injection for losing weight” or “the Hollywood drug” and an application that is aimed at so-called “aesthetic obesity” (i.e. losing 3 or 5 kilos), the professionals placed particular emphasis on the fact that it is a medical treatment, i.e. it must be indicated, prescribed and adhered to Then consult a doctor.

In addition, they clarified that the treatment is a complement to a Change of habits based on healthy eating and regular physical activity.

In the world there has been since 1975 tripled The number of people with obesity is increasing, and according to the World Health Organization (WHO), it is now a problem that affects more than a billion people.

As shown by the latest National Survey of Risk Factors (ENFR), we know that it is increasing in our country and it is estimated that this is the case between 6 and 7 people are overweight or obese.

When analyzing your CausesNutritionist Mónica Katz – who pioneered this introduction in her column in this section – pointed to both genetics and the inferior options offered by the market, such as stress, lack of exercise, portion sizes and lack of sleep, among others.

He also explained this in detail Risks about suffering from it: He was referring to everything from cardiovascular disease to cognitive impairment to chronic kidney disease.

Taking all this into account, says María Silvina Guaita, medical director of Adium Argentina (the laboratory that locally markets the drug developed by Lilly), with this drug it is possible to achieve with the highest doses, decreased by 26% of body weight, as opposed to the 17% achieved with existing options.

However, as Katz admitted, the average decline is aroundl 20 or 21%, Results that, in his opinion, have only been achieved with bariatric surgery.

“From a cardiovascular perspective, obesity for many years because it was not taken into account as an independent risk factor until cardiovascular disease (CD) was found to be directly related to obesity risk factor,” Tartaglione explained.

In this sense, Guaita assured that this drug improves cardiometabolic parameters Key factors such as a 19% reduction in waist circumference, 52% reduction in blood pressure and fatty liver disease.

In addition, it reduced the value of triglycerides, led to the restoration of normal blood sugar levels and improved HDL and LDL levels.

In the case of prediabetes, tirzepatide has the potential to be successful Remissionsince one study found that those who suffered from it had normal blood sugar levels, says Guaita.

“There was a study, the longest, that involved patients with obesity and prediabetes, and the arm that was treated with tirzepatide, the 95% on average and 97% managed to reverse this prediabetes condition with the maximum dose. This not only reduces weight, but also reduces all cardiometabolic parameters and ensures that patients with prediabetes do not develop this condition,” explains Guaita.

And he adds: “If you lose more than 15% of your weight, you gain a lot more.” more benefits: The risk of celiac disease and fatty liver disease is greatly reduced, and remission of type 2 diabetes and heart failure can be achieved. It is also beneficial in patients with sleep apnea,” he pointed out.

For his part, Tartaglione added that in the past, when he treated patients with obesity, “we had nothing to give him because the drugs always posed a risk, now I can safely sit with a patient with coronary artery disease who has a bypass or a heart attack and is overweight.” I can give him medication“.

Although it depends on case by case, treatment was suggested in the presentation could become chronic.

“When I treat a patient who has cholesterol, I know that I have to give him the medication for life. The same goes for a high blood pressure patient because he has a chronic disease. And here we are talking about one chronic problemTartaglione mused.

“There are patients who have gained weight but have a lot of comorbidities. Am I taking away the benefit?” it is a disease“No one will ask you if you need to stop taking a drug.”

When asked, the nutritionist replied that the half-life of the drug was around 170 hours, a period after that is eliminated of blood without accumulating.

As reported, the side effects are the same as those previously known for the remaining options: Nausea, vomiting, stomach pain. Especially until the body gets used to being satisfied with other portion sizes.

Regarding the possibility of sudden weight gain when the drug is stopped, known as the “rebound effect,” Guaita assured that patients usually gain weight, but not restored the basic weight.

Katz assured that even in the event of weight gain up to 60% of weight loss, since the body not only reaches satiety with less, but is also accompanied by a change in habits that, as the name suggests, lasts over a longer period of time.

It gets aroundand 580,000 pesos the minimum dose and 780,000 for the 5 mg dose (currently these are the only doses in the country). This includes a one-month treatment.

Although it is not included in the Mandatory Medical Program (PMO), the laboratory is optimistic about it cover Because, according to them, providers were interested and hoped that at least the highest-risk cases would be covered, such as those requiring bariatric surgery, because it is cheaper and less invasive.

They, in turn, reported that the laboratory would make an offer upon presentation of the relevant doctor’s prescription up to 30% discountsaid Javier Waistblat, Head of Access at Adium.

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