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Revolutionary Diabetes Treatment: Say Goodbye To Insulin Shots
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Diabetic Patient's Journey to Recovery According to a South China Morning Post report, the patient had a cell transplant in July 2021. Surprisingly, after eleven weeks, he no longer needed exogenous insulin. Over the next year, he steadily reduced and then discontinued taking oral blood sugar control medications. "Follow-up examinations showed that the patient's pancreatic islet function was effectively restored," said Yin, one of the lead researchers. The patient has been insulin-free for 33 months.This discovery represents a huge step forward in diabetic cell treatment. Timothy Kieffer, a professor at the University of British Columbia, applauded the work, saying, "I think this study represents an important advance in the field of cell therapy for diabetes."
Diabetes is a chronic disorder that impairs the body's capacity to convert food into energy, resulting in serious complications if not treated properly. Traditional therapies include insulin injections and regular monitoring, which can be taxing for patients.
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Innovative Approach to Treating Diabetes with Cell Therapy The new therapy involves programming the patient's peripheral blood mononuclear cells and changing them into "seed cells" to regenerate pancreatic islet tissue in a controlled environment. This strategy takes advantage of the body's regenerating powers, a growing discipline known as regenerative medicine."Our technology has matured and it has pushed boundaries in the field of regenerative medicine for the treatment of diabetes," said Yin.
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Implications of the Novel Cell Therapy in Reducing the Diabetes Burden China, which has the biggest number of diabetes sufferers worldwide, bears a significant healthcare burden. According to the International Diabetes Federation, 140 million people in China have diabetes, with 40 million requiring lifelong insulin injections. This novel cell therapy could greatly alleviate the burden.Kieffer stated that if this cell therapy strategy is successful in larger research, "it can free patients from the burden of chronic medications, improve health and quality of life, and reduce healthcare expenditures." However, he underlined the importance of conducting additional trials with more patients to corroborate these encouraging results.
Reference:
Here's The Skinny: Diabetes Drug Ozempic Is Hugely Popular As A Weight Loss Wonder
Editor's note: This story first posted on June 11, 2023.
For Diane Lang, the big push to focus on her health and weight came from her grandchildren.
"I was exhausted," she said. "When they would visit, I would just try to keep up with them. I want to run with them and play with them. I want to be here for as long as I can for them."
"You get to that age where you think, 'I'm going to be 60. I have to get healthy.' "
Lang, of Winfield, Butler County, decided to start taking the prescription drug Ozempic in January. The diabetes treatment has soared in popularity as a weight loss wonder drug.
Hyped on social media and name-dropped by celebrities, medicines like Ozempic, Wegovy and Mounjaro are in the spotlight as a way not only to control diabetes but also to drop weight fast. They're being eyed as treatments for other conditions, too, such as Alzheimer's and nonalcoholic fatty liver disease.
Since Lang started on Ozempic, her cholesterol level and A1C, which measures blood sugar, have dropped. She said she has lost about 25 pounds.
Lang works with a nutritionist on meal plans, which focus more on wellness and moderation than deprivation or prepackaged foods. Mostly, she said, the drug reduced her appetite so she simply isn't eating as much.
She said she has not yet been affected by supply shortages.
Another tool
Dr. George Eid, a surgeon at Allegheny Health Network who has expertise in bariatric surgery, said the hype around these medicines comes from them being "more effective than anything we've ever had."
As the use of the medicines in weight management skyrocketed, so did their cosmetic use in Hollywood and on TikTok. However, wanting to drop a few vanity pounds is a lot different than dealing with obesity, especially in a country where a significant portion of the population struggles with it.
"When you treat obesity, you're avoiding tons of other problems," Eid said. "This isn't about a size of a dress or pants. A lot of diseases are related to weight."
Nineteen states and two territories have at least 35% of residents with adult obesity — more than doubling the number of states with a high obesity prevalence since 2018 — according to data from the Centers for Disease Control and Prevention released in 2022.
That can lead to increased risk for other serious health conditions such as heart disease, stroke, diabetes, some cancers, severe outcomes from covid-19 and poor mental health. Additionally, many people are stigmatized because of their weight, the CDC noted.
Eid said the use of the drugs for weight management, if prescribed correctly, is a key public health tool and another resource in treating a chronic, complex disease.
He said he believes the public needs to better understand that weight is not about laziness or poor willpower. There are numerous factors that play a role, many of which are out of a person's control.
Medications like Ozempic have been around for about a decade and were intended for patients with diabetes because they improve insulin production. Weight loss was another result. Studies went on to show that, on average, patients lost about 15% of their body weight over a year, Eid said.
Danish pharmaceutical giant Novo Nordisk said supply capacity of Wegovy, the purely weight-loss version of Ozempic, "is gradually being expanded."
The company is pausing some key promotional efforts while dealing with low inventories.
"We will closely manage Wegovy shipments to wholesalers in the U.S. With a plan to create a more steady level of inventory, despite supply constraints," Novo Nordisk said in a filing with the Securities and Exchange Commission.
Dr. Jerry Taylor, an emergency medicine physician who runs New You Skin and Body Spa in Buffalo Township, said he lost 60 pounds since he began taking the drug in October. He prescribes drugs like Ozempic to help people manage obesity.
"It's tremendously effective," said Taylor, who weighed 260 pounds when he began taking the medicine. "I did research and saw the results that other people were getting with the medication. I don't say this about too many other things, but I think it's a game-changer.
"Most of my patients are losing about 20% of their body weight. One lost 100 pounds in six months."
The challenge has been getting these drugs into the hands of people who can benefit from them and the high price tag — one month of the drug can cost around $1,000, and getting it covered by insurance isn't a guarantee.
"It's been difficult getting it in the hands of patients, and a lot of people can really benefit from it," Taylor said. "My focus is on preventative medicine, so if we can get people to an ideal body weight, we can manage and prevent illness. You can prevent heart disease, kidney disease, all of those comorbidities.
"This class of medication is probably the most effective class of medications we've had to manage obesity, which is why it's so popular right now. It's popular because it works."
Different factors at play
About 100 genes have been identified as playing a role in weight, Eid said. Another factor is a person's environment — the type of food available, stress, lack of sleep, activity levels. Yet another factor is hormones — hunger and satiety hormones and others that influence the metabolism.
"The notion that being overweight is a matter of personal choice is so wrong," Eid said. "It's a chronic and complex disease. It's a chronic disease the same as high blood pressure, the same as diabetes.
"It's not as simple as 'Stop eating and exercise.' Lifestyle is a huge component, but it's just like when someone has high blood pressure — we ask them to have a low sodium diet along with their other treatments. With heart disease, they may have surgery and medication, but there are lifestyle changes like stopping smoking, controlling blood sugar and so on."
Some patients may be on the prescription permanently, he said, akin to prescriptions for, say, high blood pressure.
'A new era'
Wegovy and Ozempic are part of a class of medications that activate a hormone known as GLP-1. They are two versions of the same medication, semaglutide. Eli Lilly's Mounjaro targets that hormone as well. They all have a list price around $1,000.
"This whole class of medicines is going to be very effective. And so that's where all the excitement and the shortages (are) coming from because everyone's realizing, 'Wow, this is a new era in medicine,' " said Dr. Jaideep Behari, a transplant hepatologist with UPMC.
Behari, director of the UPMC Fatty Liver, Obesity and Wellness Clinic, noted the drugs are being studied as a possible treatment for nonalcoholic fatty liver disease.
"Until now, there was no effective therapy outside of surgical weight loss," Behari said.
But, doctors caution, the drugs are not a magic bullet.
"It has to be closely supervised by a professional," said Taylor of New You Skin and Body Spa.
As for side effects like nausea, vomiting, diarrhea and constipation, he said starting at a low dose and going up can help manage those issues.
He eased off the medication when he reached his goal weight. He works with others to do the same, while coaching them on how their relationship with food and leading a healthier lifestyle are keys to permanent weight loss. His goal is for them to eventually stop taking the medication for weight loss, if possible.
As for people taking the medication to look good on the red carpet, Eid of AHN said it takes away from those who need it for legitimate health concerns.
"Like with any other medication, it has to be done in a controlled setting. It has to be done as part of a program. It has to be done as part of a whole care," Eid said, adding that side effects like gastrointestinal issues need to be monitored.
Still, the medicines aren't for everyone — not everyone is going to respond to it well.
"It's an extra tool in my toolbox," Eid said. "That's helping me take care of many more patients."
Switching To Tirzepatide From GLP-1 RAs Shows Promise In Diabetes Treatment, Unravels Study
USA: In the realm of diabetes management, a significant shift is underway with the emergence of tirzepatide as a potential game-changer. A recent study has shed light on the clinical expectations during the first 12 weeks of treatment when transitioning from glucagon-like peptide-1 (GLP-1) receptor agonists to tirzepatide 5 mg. This research heralds a new era in diabetes therapeutics, offering fresh hope for patients grappling with the complexities of glycemic control.
The study found that switching from stable GLP-1 receptor agonist treatment to tirzepatide was effective and safe for patients with type 2 diabetes. Patients experienced additional weight reduction and improved glycemic outcomes with an acceptable risk of adverse [gastrointestinal] events during the first 12 weeks.
The findings were presented at an American Association of Clinical Endocrinology meeting and published in Endocrine Practice.
Tirzepatide, a novel dual glucose-dependent insulinotropic polypeptide (GIP) and a glucagon-like peptide-1 receptor agonist has garnered attention for its potent glucose-lowering effects and weight management benefits. Serge Jabbour from Thomas Jefferson University in Philadelphia, Pennsylvania, and colleagues aimed to describe the clinical course in terms of body weight, glycemic outcomes, and adverse events during the first 12 weeks following a switch from GLP-1 receptor agonists directly to tirzepatide 5 mg in a prospective study.
It included participants ≥18 years with type 2 diabetes (T2D), body mass index ≥25 kg/m2, glycated hemoglobin (HbA1c) ≥6.5% to ≤9.0%, and were on a stable treatment dose of GLP-1 RAs (semaglutide once-weekly [0.5, 1.0, 2.0 mg], liraglutide every day [1.2, 1.8 mg], or dulaglutide once-weekly [0.75, 1.5, 3.0, and 4.5 mg]) for ≥3 months at baseline.
The primary endpoint was HbA1c change from baseline at week 12. Secondary endpoints were the change from baseline in body weight, fasting serum glucose, and glucose assessed by continuous glucose monitoring. Safety was also evaluated.
The following were the key findings of the study:
In the prospective study, when patients with type 2 diabetes on stable GLP-1 RA treatment were switched directly to tirzepatide 5 mg, they experienced additional weight reduction and improved glycemic outcomes with an acceptable risk of adverse gastrointestinal events over 12 weeks.
Reference:
Jabbour S, Paik JS, Aleppo G, Sharma P, Gomez Valderas E, Benneyworth BD. Switching to Tirzepatide 5 mg From Glucagon-Like Peptide-1 Receptor Agonists: Clinical Expectations in the First 12 Weeks of Treatment. Endocr Pract. 2024 May 8:S1530-891X(24)00515-9. Doi: 10.1016/j.Eprac.2024.05.005. Epub ahead of print. PMID: 38723893.
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