Dr. Jaiwant Rangi explains tirzepatide, a new diabetes and weight-loss drug that works on two hormone pathways to reduce appetite and improve blood sugar control. In trials it beat semaglutide, with patients losing up to 22-25% of body weight. The catch: it costs roughly $1,000 a month, causes nausea and diarrhea in many people, and benefits stop when you quit.
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Foreign. Hello, Dr. Renge here. Just wanted to go over a new medication that's making a lot of news these days. It's called Tirzepatide. It's a drug also called Mounjaro. This was approved by FDA on May 13. It's a drug that is made by Eli Lilly and there are few articles that have come out in New England Journal of Medicine in the last few months that have made lot of news in the national TV and social media and we're getting a lot of questions and calls about this. Now what is so interesting about the medication, this is the first medication or the drug in this class where there's a combination of two peptides that came out individually in the past and now they've put it together. So it's called the dual incretin effect or peptides. These peptides work on the gut and the gut brain axis and they work on various different organs including liver, pancreas, making our own insulin work much better, slowing the gastric emptying and controlling the appetite and also slowing the new glucose production by the liver. So having said that this is how the drug works, why are we so excited? We are excited because this medication has shown that benefits that have been exceptionally surprising or really amazing. Something that all our patients and providers would love to know. There have been trials that have been done against semaglutide, which is another GLP1 agonist, and it has shown superiority in regards to diabetes control and weight loss against 1mg semaglutide. And there have been weight loss trials in which case they have been shown to clearly help with signal significantly with the weight loss above and beyond what has been shown in the past, in some cases going up as high as 22 to 25% of the weight loss reduction, which has never been seen before with any medication. And this is comparable to something that we normally see in a gastric bypass or surgical results. In addition to that, there are some other things that we need to keep in mind. It's nothing comes all good, right? So there are some kind of side effects and other concerns that we have as well. So what are some of the important things to keep in mind? Number one, the drug is expensive. It's about $1,000 a month and depending on your insurance it may or may not be covered. However, once you take it, you may not be able to tolerate the side effects. In about 40% of patients they had nausea and over time some patients also had some diarrhea and const constipation as expected. GI side effects or gastrointestinal side effects because the molecule works on the gut. Having said that, you also have to understand that this is not the medication that has been shown to do the benefit and seal the benefit, because once you stop the medication, you may lose that benefit. And now the weight gain can come up again. Unless we find these kind of results in trials in the next few years so far, you have to continue the medication to see all the benefits. So all in all, I think nothing can replace diet and lifestyle. We have to continue to make the best of our dietary changes and exercise plans and use it as a foundation to prevent chronic conditions and to prevent cardiometabolic complications from weight and diabetes. As a diabetologist, it's very exciting to have something like this as an option for our patients. And I think it's definitely very exciting to see such amazing drugs coming out in the market. And the benefit is also for patients because they're seeing a lot more benefit out of the medication. Not just the glucose control, but also the weight loss, also improvement in the cardiometabolic profile. This drug yet has to prove the cardiometabolic cardiovascular outcomes that it truly benefits. However, there are drugs in the similar class that have in the past shown much less cardiovascular events or complications from diabetes and obesity. So we must use the appropriate medications that have the right label for using in certain kind of high risk patients. I hope this has been helpful and we are excited to use this in our practice. If you feel you would like to be evaluated, we are happy to take you up as a new patient. Our number is 530-677-0700 and we are very passionate about diabetes, obesity and cardiometabolic complications. Thank you so much for your time.
