Obesity real risk for blood sugar: Why weight loss drugs are preventing other diseases too

A GLP1 receptor agonist, semaglutide mimics the incretin hormone in the gut to stimulate insulin production in response to sugar overload. We know that fat cells have a lot of receptors for the Covid virus, so obesity is definitely high risk. Apart from weight reduction, it boosts functioning of the kidney, liver, and perhaps the immune system, all of which can reduce severity of a virus infection.

BETTER OBESITY CONTROL

The once-weekly shot of tirzepatide (brand name Mounjaro), which combines GLP-1 and GIP mimicking hormones, to regulate blood glucose levels and even ensure fat burn. Across all doses and trials, women users lost up to 24.6 per cent of their body weight compared to 18.1 per cent in men. This is a huge drop. The findings, presented at EASD, could lead to more personalised and lasting treatment plans.

WHAT CHANGED WITH WEIGHT LOSS DRUGS?

Other studies have shown that Wegovy can reduce heart-disease-related death by 20 per cent. Although some questions were raised about confounding factors — whether those who were treated with these drugs had a better profile before they used them — most agreed that such drugs were pluripotent. Which means that these are equally effective in preventing other conditions like cancer and brain disorders. They are now being studied for inducing changes in eating behaviour, like snacking, which has been shown to come down drastically among users. Studies are ongoing to assess if there is reduction in liver fat and improved kidney functioning post the drug-induced weight loss.

DIABETES REMISSION POSSIBLE IF YOU MANAGE PREDIABETES

My paper was on reversing prediabetes — a condition when your sugar levels are elevated but not high enough to qualify as diabetes. At the stage of prediabetes, the pancreatic beta cell function (which regulates insulin secretion) is much better preserved. So the insulin resistance is not as high as in the stage of diabetes.

We have shown that South Asians, including Indians, in the stage of prediabetes needed to reduce their weight by just 2.5 kg to achieve reversal and subsequent diabetes remission. A remission of five years at this early stage means benefits could extend to 10 to 15 years.

This kind of weight loss can be achieved by stepping up on normal aerobic exercises. Our studies have shown that even a 10 per cent reduction in carbohydrate intake can help achieve remission with a compensatory 10 per cent increase in the protein intake. If the calorie restriction is continued for a longer period, say two to three months, then the fat in the pancreas begins to melt. As a consequence, the pancreatic insulin secretion by the beta cells improves. Over time a person can achieve remission.

(Dr Mohan is Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai)