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"When you decrease the weight, that also improves the metabolic parameters. The A1c goes down, it helps bring the fasting glucose down, including even liver parameters," she explained.
Expert endocrinologist Tina Thethi, MD, MPH, spoke at Pri-Med Midwest 2022 about the swiftly progressing developments in the treatment of diabetes. In addition to clinical medicine, Thethi is an associate investigator at AdventHealth Translational Research Institute.
Just before her presentation, “Where Are We Now? The Integral Role of GLP-1 RAs in the Treatment of Type 2 Diabetes Mellitus” where she took the stage with Frank Lavernia, MD, she addressed some key questions with HCPLive.
GLP-1 (glucagon-like peptide-1) receptor agonists (RAs) have been associated with reduced major adverse cardiovascular events (MACE) as shown through data yielded from clinical trials. Thethi shared insight on how she decides what treatment is appropriate for a patient.
"When you have an agent that does help reduce the atherosclerotic burden, that certainly weighs quite heavily when making a decision to reduce atherosclerotic events," she explained. "There have been studies that have shown a reduction in non fatal stroke with some of the GLP-1 RAs."
A constant topic of conversation throughout the conference was tirzepatide. While it's already been approved for type 2 diabetes, the once-weekly combination GIP (glucose-dependent insulinotropic polypeptide) receptor and GLP-1 receptor agonist was just granted Fast Track designation by the FDA for treating adults with obesity, or overweight with weight-related comorbidities.
"Tirzepatide has shown a reduction in A1c, and reduction in weight loss as well," Thethi said. "Now, all the GLPs let us look across the spectrum, they lead to some degree of weight loss, varying drugs with varying doses have different weight loss percentages."
She acknowledged that even liver damage caused by a buildup of fat in the liver, or nonalcoholic steatohepatitis (NASH), has improved with this therapy as a resulting impact of weight loss.
"When you decrease the weight, that also improves the metabolic parameters. The A1c goes down, it helps bring the fasting glucose down, including even liver parameters," Thethi said in the interview.