Why it's important to have a doctor following you closely when you are on GLP-1s

(Semaglutide, Ozempic, Wegovy, Liraglutide, Saxenda, Tirzepitide, Mounjaro, Zepbound)

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications used for the treatment of type 2 diabetes and obesity. While highly effective, these drugs are associated with side effects that can be challenging to manage. Proper physician guidance and familiarity GLP-1s is crucial for mitigating these adverse effects and allowing for successful treatment adherence. Unresponsive primary care providers and online services can fall short in this critical support. At Mission Metabolic Health we ensure that any side effects that may arise are promptly and effectively managed which allows for our patients success on these medications.

The most common side effects of GLP-1 receptor agonists are gastrointestinal in nature, including nausea, vomiting, diarrhea, and constipation {Citation 1}, {Citation 2}. These side effects are typically mild to moderate in severity but can be disruptive and lead to treatment discontinuation if not managed appropriately. At MMH we focus on avoiding GI and other side effects with proper use of GLP-1 medications and then work with our patients to manage any side effects that arise.

We all can relate to the misery of feeling nauseated. This is a real but usually very manageable issue we can face when using GLP-1 medications. A meta-analysis of 236 clinical trials found that GLP-1 receptor agonists were associated with a higher rate of adverse events leading to treatment discontinuation compared to oral antidiabetic agents {Citation 3}. Nausea, in particular, is a frequent side effect, occurring in up to 50% of patients treated with exenatide twice-daily and 26% with exenatide once-weekly {Citation 3}. There is not much purpose in writing for these medications if you experience side effects and are forced to stop them. MMH will manage these side effects so you can be successful in losing weight.

Importance of Physician-Guided Follow-up

Effective management of GLP-1 receptor agonist side effects requires close collaboration between patients and doctors. A randomized controlled trial (SUSTAIN 7) evaluating the safety and efficacy of semaglutide (Wegovy, Ozempic), reported nausea, vomiting, and diarrhea rates of 15%, 9%, and 12.3%, respectively, in the semaglutide group {Citation 4}.

Regular follow-up with a physician is essential for several reasons and this is where Mission Metabolic Health excels:

1. Dose Titration: Gastrointestinal side effects are often dose-dependent, and gradual dose escalation can help mitigate their severity {Citation 1}, {Citation 2}. Mission Metabolic Health’s close followup guides patients through the appropriate dose titration schedule and makes the fine necessary adjustments.

2. Symptom Management: MMH provides specific recommendations for managing nausea, vomiting, diarrhea, or constipation, such as dietary modifications, hydration strategies, or adjunctive medications.

3. Early Intervention: Prompt identification and management of side effects can prevent treatment discontinuation and improve adherence {Citation 2}. MMH intervenes early and adjusts the treatment plan accordingly.

4. Monitoring for Serious Adverse Events: While rare, GLP-1 receptor agonists have been associated with potential adverse events like pancreatitis and gallbladder disease {Citation 3}.Our plans provide close follow up to monitor for and address these complications promptly in the rare case they arise.

 

While GLP-1 receptor agonists are highly effective for the management of type 2 diabetes and obesity, their gastrointestinal side effects can be challenging. Proper guidance is crucial for mitigating these adverse effects, ensuring treatment adherence, and maximizing the benefits of these medications. Regular follow-up, dose titration, symptom management strategies, and early intervention can significantly improve patient outcomes and reduce the risk of treatment discontinuation {Citation 2}, {Citation 4}. This is where Mission Metabolic Health excels. If you're considering a GLP-1 make sure you do it the right way with a physician who will monitor you closely and be responsive if any issues arise. GLP-1s are powerful tools but like any tool they are most effective and safe in skilled hands, this is our role at MMH.

References

1. Nauck, M. A., & Meier, J. J. (2019). Incretin hormones: Their role in health and disease. Diabetes, Obesity and Metabolism, 21(S1), 5-21. doi:10.1111/dom.13682

2. Buse, J. B., Wexler, D. J., Tsapas, A., Rossing, P., Mingrone, G., Mathieu, C., ... & Davies, M. J. (2020). 2019 update to: Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 43(2), 487-493. doi:10.2337/dci19-0066

3. Monami, M., Dicembrini, I., Nardini, C., & Mannucci, E. (2014). Glucagon-like peptide-1 receptor agonists and pancreatitis: A meta-analysis of randomized clinical trials. Diabetes Research and Clinical Practice, 103(2), 269-275. doi:10.1016/j.diabres.2013.12.048

4. Pratley, R. E., Aroda, V. R., Lingvay, I., Ludemann, J., Andreassen, C., Navarria, A., & Viljoen, A. (2018). Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): A randomised, open-label, phase 3b trial. The Lancet Diabetes & Endocrinology, 6(4), 275-286. doi:10.1016/S2213-8587(18)30024-X