Data on people with diabetes show that compared to drugs like glipizide, drugs like semaglutide have significant advantages.
Dr. Dear Roach: I have type 2 diabetes. My BMI is 29. My last A1C was 8.4%. I am currently taking metformin and glipizide. I have asked my doctor about new drugs, like Ozempic and Mounjaro, but he is reluctant to give them. We talked about it twice, and he told me that I have to take it for the rest of my life. He also said that if I stop it, the weight will come back.
I’ve been overweight most of my life, and it’s hard for me to lose weight. What is the difference between taking Mounjaro or Ozempic for the rest of my life or metformin and glipizide for the rest of my life?
Also, my friend who is a nurse says it will damage my kidneys and liver, and she is against taking these medications. He said he knows someone who had to go on dialysis after taking Mounjaro. If these meds can help me lose weight and keep it off while my A1C goes down, why not take them?
RB
I am cautious about recommending semaglutide for weight loss. (When prescribed for diabetes, the brand name for semaglutide is Ozempic, but for weight loss, it is Mounjaro.) However, it is clear that some people find it very useful, or it can even be a lifelong cure. It is indicated by the Food and Drug Administration for weight loss in people with a BMI greater than 30.
For the treatment of diabetes, I am not so skeptical. You may want to use it for diabetes, but weight loss is an added benefit. Data on people with diabetes show that compared to drugs like glipizide, drugs like semaglutide have significant advantages. They reduce the risk of heart disease by 20% and the overall risk of death by about 33%. Unlike what your nurse friend said, there is no evidence of kidney or liver damage from semaglutide or similar drugs.
Since there is strong evidence of improvement in the most important areas (longer life and prevention of heart disease), drugs such as semaglutide may provide you with significant benefits.
Dr. Dear Roach: I developed a blood clot in my left leg in 2019 after a short hospital stay. I haven’t had anything and haven’t had any news since. Tests every six months show that there is calcium at the site of the clot. All the doctors say it doesn’t move. It’s not going anywhere, and I shouldn’t be taking warfarin five years later.
My hematologist said I would have to be on it for the rest of my life, but I haven’t seen it since. I want to get off of it, as I’m more worried about the bleeding than if it will go to the lungs.
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I don’t know why your hematologist recommended lifelong therapy. Generally, when there is a risk factor for the clot, such as hospitalization or surgery, anticoagulation with warfarin is continued for three to six months in people without risk factors. , such as genetic predisposition or active cancer.
In people who have recurrent heart attacks, especially if they are life-threatening, or in someone who is at higher risk, life-long treatment is recommended. Bleeding is not helpful in people with no new symptoms.
I would ask your primary care physician if you can stop the anticoagulation, and if they are not willing to do so, you should be referred to a hematologist.
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