GLP1RAs were found to be safe and not associated with a higher incidence of adverse events compared to other anti-obesity medications in patients post-bariatric surgery. Initiating AOMs more than 12 months after surgery was associated with a lower risk of AEs.
Both GLP-1RAs and SGLT-2is led to significant weight loss (at least 5%), improved HbA1c levels, and reduced blood pressure, with semaglutide 2.4mg showing the greatest efficacy in these outcomes.
The study suggests that while AOMs can lead to weight loss, there may be compensatory reductions in lifestyle changes, indicating that individuals may not engage in healthy behaviors as expected after starting medication.
The study estimates that expanding access to these weight-loss medications could avert over 43,000 deaths annually in the US, including more than 12,000 deaths among individuals with type 2 diabetes. This highlights the potential life-saving impact of making these treatments more accessible to those in need.
Patients reported an average weight loss goal of 65.8 kg from bariatric surgery, which is 39% of their baseline weight. The use of AOMs was associated with improved motivation for surgery, with patients citing better longevity and quality of life as key reasons for seeking surgical intervention.
GLP-1RAs modestly reduced systolic blood pressure (SBP) compared to placebo, with significant reductions noted for semaglutide, liraglutide, dulaglutide, and exenatide. Only exenatide showed a significant reduction in diastolic blood pressure (DBP).
Liraglutide and diet led to weight loss, improved insulin resistance, and reduced levels of plasminogen activator inhibitor-1 (PAI-1) and the inflammatory chemokine MCP-1. However, no treatment improved flow-mediated dilation (FMD) in participants with normal endothelial function.
The study found that the use of GLP-1 and SGLT-2 medications increased from 1.4% in 2005-2006 to 13.3% in 2017-2020 among T2D patients. Higher education levels and income were associated with increased usage of these medications, indicating improved access and adherence among these groups.
The study found that among individuals with type 2 diabetes, 13.6% were prescribed GLP-1RAs and 11.5% SGLT2i, with one-year fill rates around 52.5% for GLP-1RAs and 52.9% for SGLT2i, indicating some level of adherence to treatment.
SGLT2I users showed significantly lower risks of myocardial infarction (HR: 2.91) and heart failure (HR: 2.49) compared to non-SGLT2I users, indicating a protective effect against these cardiovascular events.
The treatment resulted in the identification of 70 urinary peptides significantly affected by GLP-1R agonist treatment, indicating a beneficial effect on kidney and vascular health by downregulating peptides associated with damage.
Post-OGTT insulin secretion (disposition index) was significantly increased in the GB group compared to SG and non-operated controls, indicating a unique adaptive response in insulin secretion following GB.
Both SGLT2is and GLP1-RAs were associated with a lower risk of major adverse cardiovascular events (MACE) compared to DPP4is and SUs, with SGLT2is showing an 11% lower risk and GLP1-RAs showing a 17% lower risk of cardiovascular events.
Mirabegron effectively stimulated BAT thermogenesis and whole-body energy expenditure at high doses, but this effect was diminished when combined with bisoprolol.
HAMS-AB intake is anticipated to improve gut microbiome profile, increase SCFA production, enhance β-cell health and function, improve glycemia, and modulate immune responses in youth with T1D.