{"id":361047,"date":"2023-07-26T00:02:00","date_gmt":"2023-07-25T22:02:00","guid":{"rendered":"https:\/\/medizinonline.com\/?p=361047"},"modified":"2023-06-23T23:33:24","modified_gmt":"2023-06-23T21:33:24","slug":"tackling-obesity-not-only-diabetics-benefit-from-the-effects","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/tackling-obesity-not-only-diabetics-benefit-from-the-effects\/","title":{"rendered":"Tackling obesity – not only diabetics benefit from the effects"},"content":{"rendered":"\n

While glucagon-like peptide (GLP)-1 receptor agonists have been successfully used in the treatment of diabetes for some time, there are now agents that activate not only the GLP-1 receptor but also the glucose-dependent insulinotropic polypeptide (GIP) receptor. Dual GLP-1\/GIP agonists are considered promising new drugs for the treatment of obesity and type 2 diabetes.<\/strong><\/p>\n\n\n\n

Incretins such as glucagon-like peptide 1 (GLP-1) or gastric inhibitory peptide (GIP) are gut hormones that promote insulin release. The peptide hormone GIP is released from the duodenum into the blood after a meal. Together with GLP-1, GIP stimulates insulin secretion from pancreatic beta cells. In overweight type 2 diabetics with a body mass index (BMI) \u226528 kg\/m2<\/sup>, the current treatment recommendations of the Swiss Society of Diabetology and Endocrinology (SGED) advise an early combination of metformin with GLP-1 receptor agonists (GLP-1-RA), as the latter have shown greater effects than SGLT-2 inhibitors (SGLT-2-i) in terms of weight reduction [1]. GLP-1 RAs with high potency with respect to weight loss include semaglutide or, at higher doses, liraglutide and dulaglutide [1]. In trials, semaglutide at a dose of 2.4 mg and the new GLP-1\/GIP agonist tirzepatide have performed best in this regard to date. In Switzerland, tirzepatide has been approved for the treatment of adult type 2 diabetics since September 2022 [2]. <\/p>\n\n

First GLP-1\/GIP agonist convinces in overweight people with and without diabetes<\/h3>\n\n

The SURPASS-1 trial evaluated the efficacy and safety of tirzepatide (5 mg \/10 mg\/15 mg) compared with placebo in adults with type 2 diabetes [3]. After 40 weeks of treatment, tirzepatide at all three doses resulted in above-average reductions in blood glucose and body weight compared with baseline values. Participants had a mean duration of diabetes of 4.7 years, a baseline HbA1c<\/sub> of 7.9%, and a baseline weight of 85.9 kg. Tirzepatide resulted in a reduction in HbA1c<\/sub> of 1.87% (5 mg), 1.89% (10 mg), and 2.07% (15 mg), respectively, whereas there was an increase of +0.04% in the placebo condition. There was also a dose-dependent effect with regard to weight reduction: -7.9% (5 mg) and -9.3% (10 mg) and -11.0% (15 mg), respectively. This corresponds to a significant superiority compared to placebo (-0.9%). <\/p>\n\n

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In the SURPASS-5 study, adults with inadequately controlled type 2 diabetes received tirzepatide as an adjunct to insulin glargine and metformin. Of the 475 randomized type 2 diabetic patients (44% female; mean age 60.6 years; mean HbA1c <\/sub>8.31%), 451 underwent the entire study [4]. Inclusion criteria included baseline HbA1c<\/sub> of 7.0% to 10.5% (53-91 mmol\/mol), BMI of min. 23 and therapy with stable doses of once-daily insulin glargine (>20 IU\/d or >0.25 IU\/kg\/d) with or without metformin (\u22651500 mg\/d). In all tirzepatide doses (5 mg\/10 mg\/15 mg), a considerable weight reduction was achieved from baseline to week 40, whereas in contrast, a slight weight gain occurred in the placebo arm (Fig. 1, Fig. 2) <\/strong>. The dual GLP-1\/GIP agonist was also convincing in terms of glycemic control. The mean change in HbA1c<\/sub> in the study arms with tirzepatide at the above doses was -2.11% and -2.40% and -2.34%, respectively. In the placebo condition, the corresponding value was -0.86%. <\/p>\n\n

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That tirzepatide is also effective in obese patients without diabetes is shown by data from the SURMOUNT-1 trial [5]. At baseline, mean body weight was 104.8 kg and mean BMI was 38.0. 94.5% of the participants had a BMI of min. 30 on. At week 72 after baseline, weight reduction of 15.0% (5 mg), 19.5% (10 mg), and 20.9% (15 mg), respectively, was achieved in the tirzepatide study arms, corresponding to significant superiority over placebo (p<0.001, all doses). A weight reduction of at least 5% achieved with tirzepatide 5 mg\/10 mg\/15 mg was 85% and 89% and 91% of study participants, respectively. In conclusion, GLP-1-RA and the GLP-1\/GIP agonist tirzepatide have an important role in the treatment of obesity and diabetes.<\/p>\n\n

Literature: <\/p>\n\n

    \n
  1. Gastaldi G, et al: Recommendations of the Swiss Society of Endocrinology and Diabetology (SGED\/SSED) for the Treatment of Type 2 Diabetes Mellitus, 2023, www.sgedssed.ch,<\/a>(last accessed 06.06.2023).<\/li>\n\n\n\n
  2. Drug Information, www.swissmedicinfo.ch,<\/a>(last accessed 06.06.2023). <\/li>\n\n\n\n
  3. Rosenstock J, et al: Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet 2021; 398(10295): 143-155.<\/li>\n\n\n\n
  4. Dahl D, et al: Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes. The SURPASS-5 Randomized Clinical Trial. JAMA 2022; 327(6): 534-545.<\/li>\n\n\n\n
  5. Jastreboff AM; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022; 387(3): 205-216.<\/li>\n\n\n\n
  6. “Goals and benefits of effective obesity management – 2023 update,” Professor Dror Dicker, MD, DGIM Congress 04\/24\/2023.<\/li>\n<\/ol>\n\n

    HAUSARZT PRAXIS 2023; 18(6): 28<\/em><\/p>\n\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

    While glucagon-like peptide (GLP)-1 receptor agonists have been successfully used in the treatment of diabetes for some time, there are now agents that activate not only the GLP-1 receptor but…<\/p>\n","protected":false},"author":7,"featured_media":361066,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"GLP-1-RA and dual GLP-1\/GIP agonists.","footnotes":""},"category":[11508,11384,11297,11388,11548,11503],"tags":[11655,21334,19610,65608,69540,69547,69554,18544,12390,12389,17444,69567,69561],"powerkit_post_featured":[],"class_list":["post-361047","post","type-post","status-publish","format-standard","has-post-thumbnail","category-education","category-endocrinology-and-diabetology","category-general-internal-medicine","category-nutrition","category-rx-en","category-studies","tag-diabetes-en","tag-dulaglutide","tag-glp-1-en","tag-glp-1-ra-en-2","tag-glp-1-gip-agonists","tag-glucagon-like-peptide-1-en","tag-glucose-dependent-insulinotropic-polypeptide-receptor","tag-liraglutide","tag-obesity","tag-overweight","tag-semaglutide-en-2","tag-surpass-en","tag-type-2-diabetes-en","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-13 14:47:18","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"en_US","wpml_translations":{"fr_FR":{"locale":"fr_FR","id":361086,"slug":"combattre-lobesite-les-diabetiques-ne-sont-pas-les-seuls-a-beneficier-de-ses-effets","post_title":"Combattre l'ob\u00e9sit\u00e9 - les diab\u00e9tiques ne sont pas les seuls \u00e0 b\u00e9n\u00e9ficier de ses effets","href":"https:\/\/medizinonline.com\/fr\/combattre-lobesite-les-diabetiques-ne-sont-pas-les-seuls-a-beneficier-de-ses-effets\/"},"it_IT":{"locale":"it_IT","id":361132,"slug":"affrontare-lobesita-non-solo-i-diabetici-ne-beneficiano","post_title":"Affrontare l'obesit\u00e0: non solo i diabetici ne beneficiano","href":"https:\/\/medizinonline.com\/it\/affrontare-lobesita-non-solo-i-diabetici-ne-beneficiano\/"},"pt_PT":{"locale":"pt_PT","id":360973,"slug":"combater-a-obesidade-nao-sao-so-os-diabeticos-que-beneficiam-dos-seus-efeitos","post_title":"Combater a obesidade - n\u00e3o s\u00e3o s\u00f3 os diab\u00e9ticos que beneficiam dos seus efeitos","href":"https:\/\/medizinonline.com\/pt-pt\/combater-a-obesidade-nao-sao-so-os-diabeticos-que-beneficiam-dos-seus-efeitos\/"},"es_ES":{"locale":"es_ES","id":361015,"slug":"combatir-la-obesidad-no-solo-los-diabeticos-se-benefician-de-sus-efectos","post_title":"Combatir la obesidad: no s\u00f3lo los diab\u00e9ticos se benefician de sus efectos","href":"https:\/\/medizinonline.com\/es\/combatir-la-obesidad-no-solo-los-diabeticos-se-benefician-de-sus-efectos\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/361047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/comments?post=361047"}],"version-history":[{"count":1,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/361047\/revisions"}],"predecessor-version":[{"id":361070,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/361047\/revisions\/361070"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media\/361066"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media?parent=361047"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/category?post=361047"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/tags?post=361047"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=361047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}