Type 2 Diabetes: The U.S. Food and Drug Administration has approved terzepeptide

  • The Food and Drug Administration (FDA) has approved a new, first-class drug in its class to treat type 2 diabetes. The drug is called tirzepatide.
  • A person takes it as an injection once a week under the skin.
  • It has a dual effect, lowering blood sugar and supporting weight loss better than currently available medications for this condition.
  • The most common side effects are nausea, diarrhea, and vomiting, which seem to lessen over time. There have also been a few reports of severe low blood sugar in clinical trials.

Insulin is a hormone secreted by the pancreas that allows blood sugar to enter cells and provide fuel.

The body of a person with type 2 diabetes either does not produce enough insulin or does not respond to insulin the way it should.

Insulin resistance It occurs when the body’s cells cannot easily absorb blood sugar. In response, the pancreas produces more insulin for the cells to respond. Over time, the pancreas may not be able to meet the increased demands. this leads to prediabetes and diabetes.

in all, 11.3% Of people in the United States suffer from diabetes, and 90-95% of these cases Type 2 diabetes.

Uncontrolled high blood sugar can lead to serious complications, such as Chronic kidney failureAnd blindnessAnd brain attack.

Different types of medications can reduce blood sugar in people with type 2 diabetes. Some examples include:

  • oral medications
    • Alpha-glucosidase inhibitors
    • biguanides
    • Bile acid blockers
    • Dopamine agonists 2
    • DPP-4 inhibitors
    • meglitinides
    • SGLT2 . inhibitors
    • sulfonylureas
    • thiazolidinedione
  • Injectable Medicines

The American Diabetes Association Guidelines 2022 Say the first line treatment is usually metformin, biguanide, and Healthy lifestyle changes.

But the choice of initial treatment also depends on the presence or risk of developing other health conditions, including heart failure, coronary artery disease or chronic kidney disease. The doctor also takes into account a person’s preference, accessibility of the drug, its cost, efficacy, side effects and impact on weight.

Often, combination therapy, which includes two or more drugs, is necessary to maintain blood sugar within the appropriate range in order to delay or prevent Diabetes related complications.

But some people with type 2 diabetes can’t reach their glycemic goals with currently available combination therapies.

The need for new, more effective treatment options forms the basis of the Food and Drug Administration’s approval of terzepeptide, a new drug for type 2 diabetes.

Terzepeptide is the first drug in a new class of diabetes medications. It is a glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist.

GLP-1 And GIP Are the gut hormones called incretins, and the intestines release them when we eat. Incretins stimulate insulin secretion from the insulin-producing cells in the pancreas, called beta cells.

GLP-1 increases insulin secretion from the pancreas. It also reduces levels of glucagon, a hormone that prevents blood sugar from dropping too low.

Another role for GLP-1 increases the number and size of beta cells in the pancreas. It also promotes feelings of fullness by delaying stomach emptying and controlling appetite in the brain.

Like GLP-1, GIP increases insulin secretion. It also improves beta cell production and reduces beta cell destruction. In addition, GIP reduces fat accumulation, increases bone formation, increases glucagon production, and decreases acid secretion in the stomach.

People with type 2 diabetes do not respond as strongly to the incretin hormones as other people. Tirzepatide treats this deficiency by activating the GLP-1 and GIP receptors in the body.

at videoAnd Dr. Carol WishamA clinical endocrinologist at the Rockwood Clinic, in Spokane, Washington, and professor of clinical medicine at the University of Washington, talks about the GLP-1 and dual GIP actions of tirzepatide. She explained:

They both have somewhat separate activities, but they have [greater activities in combination], which causes insulin secretion, improved glucose tolerance, and reduced body weight. “

In a clinical trial called Sorbas -1In this study, researchers found that tirzepatide is effective in adults with diabetes that is not adequately controlled by dietary and exercise interventions alone.

Participants received one of three doses of tirzepatide: 5 milligrams (mg), 10 mg, or 15 mg, or a placebo injection under the skin once weekly for 40 weeks.

The study showed that participants who took tirzepatide had a significantly lower A1C, a measure of blood sugar, compared to the placebo group. A1C decreased by 1.87 to 2.07%, depending on the dose.

Also, compared to the placebo group, participants who took tirzepatide lost more weight: 7 to 9.5 kilograms (kg), or 15.4 to 20.9 pounds (lbs).

at SURPASS-2 experimentsIn the study, participants with type 2 diabetes received the same doses of tirzepatide as in the previous trial or a 1 mg dose of semaglutide once weekly for 40 weeks. Semaglutide is an FDA-approved GLP-1 agonist used to treat type 2 diabetes.

Terzepeptide reduced A1C from 2.01 to 2.3%, depending on the dose, while semaglutide reduced it by 1.86%.

The trial also reported a significant reduction in weight in the tirzepatide group, compared with the semaglutide group. Previously, weight loss ranged from 1.9 kg (4.2 lb) to 5.5 kg (12.1 lb).

The EXPERIENCE SURPASS-3 Compare tirzepatide with insulin degludec, another injectable diabetes medication that has already been approved by the FDA.

The study recruited subjects with type 2 diabetes who had never used insulin and had not responded adequately to either metformin alone or in combination with SGLT2 inhibitors.

After 52 weeks, participants who received tirzepatide had significantly greater decreases in A1C, compared to those who received insulin degludec. The first group also experienced significantly greater weight losses.

In the next trial, he called Sorbas -4In the study, the scientists recruited adults with type 2 diabetes who were overweight or obese and who had cardiovascular disease or were at high risk of developing cardiovascular disease.

These participants were already using one or more diabetes medications and had inadequate blood glucose control at the start of the study.

Participants received a weekly dose of tirzepatide or Insulin glargineanother injectable diabetes drug, for 52 weeks.

Once again, the participants who received tirzepatide achieved a better decrease in A1C and weight loss than those who took insulin glargine.

The EXPERIENCE SURPASS-5 It evaluated tirzepatide as an additional medicine for people with type 2 diabetes who were already taking insulin glargine, with or without metformin. The trial measured A1C level and weight reduction in participants receiving a placebo and others receiving tirzepatide once a week in addition to their previous treatment for 40 weeks.

Those who took tirzepatide as an add-on treatment achieved greater reductions in A1C and weight loss than those who received a placebo.

Dr. Laurie A. kenan endocrinologist at Providence Saint John’s Health Center, in Los Angeles, California Medical news today About terzipatide. She explained:

“Tirzepatide is unique because it combines GLP-1 plus the GIP agent in one injection, the effectiveness we are seeing in lowering glucose as well as weight [loss] More than anything we have now. […] A lot of agents on the market give us a cut of about 1% for our A1C or less, depending on the A1C levels when we start treatment.”

In study participants, the most common side effects of tirzepatide were nausea, diarrhea, vomiting and constipation. A sharp drop in blood sugar also occurred, but infrequently.

Dr. Wysham explains: “The gastrointestinal side effects of tirzepatide are very similar to […] GLP-1 agents. […] Much like studies with GLP-1 receptor agonists, nausea was greater at starting and at increasing doses, then tended to [decrease] With time.”

Researchers continue to investigate the long-term safety of tirzepatide and its potential effects on Cardiovascular outcomessuch as heart attack, stroke, and cardiovascular death.

Dr Keane commented: “As long as we use agents that do not present any hypoglycemic risk, as is the case with [tirzepatide]aim for lower A1C mode [people with type 2 diabetes] Better positioned to prevent long-term complications. Lowering the A1C to 5.7% is incredible.”

She added, “It’s probably going to be agent cost and insurance coverage that will be an obstacle in some cases, so we’ll have to wait and see how that plays out.”

MNT Also talk to Dr. Robert Gabbay, chief scientific and medical officer of the American Diabetes Association. Looking to the future, he said, he’s interested in seeing if the drug might also help treat complications related to type 2 diabetes:

“We look forward to seeing if tirzepatide can offer any benefit in cardiovascular disease,” NASH [a form of nonalcoholic fatty liver disease]and other complications, such as retinopathy, nephropathy, and polyneuropathy.”