VIDEO: How GLP-1 agonists have changed diabetes treatment

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The incretin therapies, which start with GLP-1, and now I'll look at GLP-1 and GIP, for me foundationally changed our treatment of diabetes because they have the benefit of being potent agents that will lower glucose, but they have plenty of extra glycemic benefits. And so some of them are already FDA indicated, such as the reduction of cardiovascular events in three of the agents. Reduction in stroke in two of the agents. And then all the ones that have been studied, actually have shown a reduction in kidney outcomes. So, again, this is what I would consider glucose plus.

So when I tell a patient I could give you medication A that lowers your glucose, or I could give you medication B that might help your heart, help your kidney, help you with weight loss, maybe even help you with fatty liver. And so I think now that we have agents that move within the pathophysiologic process, they really have a lot of benefit. And for me, when I'm treating diabetes, I try to use a pathophysiologic approach. And if I agree that there's at least eight pathophysiologic mechanisms, I'm going to choose complementary therapies that get to all eight, and the GLP-1 receptor agonists get to five, and the twin credence get to six. So then it's quite easy to form a plan.

Now they're not for everyone and I think because of the effects on on weight and obesity, they've gotten used much faster with a lot less supervision in a broader population and so now we're starting to see some side effects because like I take probably a good 15 minutes before we start with any GLP-1 and kind of go over the risk benefit ratio and how to be successful. But I do this every day. And so now that we're using this in a much wider population, I do think that the kind of onboarding has gotten a little bit more tricky. I hope that with time that'll get smoother. But I think they really have changed things. And I do think this is just the beginning. We're gonna have agents that are even more potent than the ones we have today.