While GLP-1 receptor agonists have revolutionized Type 2 Diabetes (T2D) care with their weight-loss benefits, are they truly addressing the root problem? 🤔
🔍 Key Concerns:
1. Insulin Resistance Ignored:
GLP-1 RAs focus on weight loss and glucose lowering but do NOT directly target insulin resistance—the core issue in T2D. This can lead to long-term stress on β-cells, worsening their function over time.
2. High Insulin Levels:
By stimulating insulin secretion, GLP-1 RAs may paradoxically increase circulating insulin levels in some patients, potentially exacerbating insulin resistance and cardiovascular risks.
3. Muscle Mass Loss:
Significant weight loss achieved with GLP-1 RAs might come at the cost of muscle mass—a major issue for older adults with T2D, increasing frailty and reducing quality of life.
💡 What’s Missing?
A focus on insulin sensitization! Thiazolidinediones (like pioglitazone) are one of the few drugs that directly improve insulin resistance, but their use is limited due to side effects. The need for novel, effective insulin-sensitizing therapies has never been greater.
📢 Call to Action:
We need to shift our focus in T2D management—from just losing weight to tackling insulin resistance and preserving muscle mass. The future of diabetes care depends on it! 💪
Abdul-Ghani, M., Maffei, P., & DeFronzo, R. A. (2024). Managing insulin resistance: the forgotten pathophysiological component of type 2 diabetes. The Lancet Diabetes & Endocrinology, 12(9), 674-680. https://doi.org/10.1016/S2213-8587(24)00127-X
Comments