The Best of Both Worlds: New Medications Can Help with Diabetes Management and Weight Loss

by Carson Herbert

October 2024

Semi-who-tide? Semaglutide! It's likely Swift County residents have heard the word, but this isn't a football score update or new laundry detergent. Semaglutide is an injectable medication that's become a new tool for weight loss. Semaglutide and similar medications belong to a group known as glucagon-like peptide-1 receptor agonists, or GLP-1 agonists for short. These drugs have been proven to help with weight loss, blood sugar control, and other health benefits. With reports of patient successes, it's hard not to wonder if these medications are worth a try.

Uff da, where to start? Before getting into how these drugs work, it's easier to first think about how food is digested. After a meal, food travels to the stomach, where digestion begins. As the stomach starts breaking down food, the small intestine releases a chemical messenger called GLP-1. This messenger travels to the pancreas, a small organ behind the stomach, and tells it to release another messenger, insulin. Insulin then travels in the blood where it tells other organs to remove excess sugars as blood sugar levels rise after meals. This messenger system keeps blood sugars at healthy levels.

How do GLP-1 medications work? In some people with type 2 diabetes, the body stops listening to insulin's signals, leading to what's known as insulin resistance and causes high blood sugars. For diabetics with insulin resistance, GLP-1 medications tell the body's organs to absorb more sugar from the blood, as insulin's message is weakened. These drugs also slow digestion, resulting in lower blood sugar levels. For diabetics without insulin resistance, GLP-1 drugs boost the body's natural GLP-1 system. This leads to more insulin release from the pancreas which lowers blood sugar levels. Overall, these actions lead to improved blood sugars and weight loss.

Can those without diabetes use GLP-1 medications too? Yes! Providers are finding that GLP-1 medications work much the same for non-diabetics as they do for those with diabetes. By slowing digestion, decreasing blood sugar levels, and promoting natural insulin release, non-diabetics also experience better blood sugar control and weight loss. Research studies are also uncovering added benefits of GLP-1 medications, in that slowed digestion may send signals to the brain that help decrease appetite and cravings. These combined actions can lead to weight loss for all patients.

Are there other benefits? Yes, again! Health studies have discovered that some GLP-1 medications can also improve heart health and reduce the risk of heart attacks. These findings are important, as obesity and diabetes are both risk factors for heart attacks.

What's the downside here? As with any medication, there are some side effects. The most common are nausea, vomiting, and diarrhea. The good news is most of these side effects ease up as the body gets used to the new medication. Other small changes, like smaller meal sizes and avoiding fatty foods may also help reduce unwanted side effects.

Additionally, patients also report weight gain after stopping these medications, some exceeding their start weight. To prevent this, providers recommend solidifying healthy eating habits while taking GLP-1 medications to help prevent this rebound weight gain when these medications are stopped.

What about the cost? New medications can be expensive. For people without insurance, out-of-pocket costs for these medications may be high. Some insurance providers, including Medicare and Medicaid, have extended coverage to include GLP-1 agonists, meaning costs could be lower. Other payment programs may also be available to help reduce costs for those who need these medications.

All in all, the worlds of diabetes management and weight loss are ever-changing. For those with more questions about GLP-1 medications, want better blood sugar control, or wanting to shed a few extra pounds, consider speaking with your healthcare provider to learn if these new medications might be beneficial for your health goals.

About the Author

Carson Herbert is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. He was selected as the Benson participant for the school's ROME program, or Rural Opportunities in Medical Education. The program focuses on teaching student doctors the importance using rural newspapers to share health information. As a future rural healthcare leader, Herbert has written this column to provide health information for his ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed provider.