TIRZEPATIDE - Something new in the diabetes world.

One of the most important developments in the treatment of type 2 diabetes over the past decade or so has been the introduction of the "incretin" agents. Incretins are hormones produced in the small intestine at mealtime that help in glucose metabolism. They have several effects but importantly they increase insulin output by the pancreas at mealtime and also signal satisfaction of hunger to the brain. Medications with these effects are marketed as weekly injections and 2 common ones are Ozempic and Trulicity, (although there are other similar ones) which usually work well to improve blood sugar and produce weight loss.

In the last couple of years diabetes experts have been excited by a new and improved variation known by the scientific name of tirzepatide, and just recently put on the market by Lilly Co. as Mounjaro so expect to see ads.

In clinical trials tirzepatide does even better than the previous agents in controlling blood sugar and reducing weight. Higher doses even seem in some cases to cause weight loss in the range of that produced by obesity surgery. So experts are thinking of it as a possible additional help in the battle against the obesity epidemic that is gradually being thought of as the major public health problem worldwide, a problem with far, far greater health implications than the Covid 19 pandemic that so dominates our news.

For the science minded among you – there are 2 main incretin hormones produced in the small intestine, GLP-1 and GIP. The former agents produce the effect of GLP-1 but tirzepatide stimulates the body's receptors for both GLP-1 and GIP. The most important side effects of all these agents are nausea and sometimes diarrhea, but given judiciously most people tolerate them well.