Among a plethora of weight-management plans and dietary charts (namely, keto, dash, sirtfood, paleo or crash diet), climbing the popularity charts, incretin hormone therapy is currently grabbing attention
At a time when both international and domestic celebrities like Oprah Winfrey, Elon Musk, Rebel Wilson, Tracey Morgan, filmmakers Hansal Mehta and Karan Johar, plus star actors NTR Junior and Priyanka Chopra Jonas are becoming a talking point for their rapidly visible weight-loss programmes, speculations are rife over how they are pursuing their kilo-shedding goals.
Thanks to incretin treatment and the aggravation of health issues like diabetes, GLP-1 receptor agonists Ozempic and Mounjaro (medicines administered alongside staple intakes and physical exercises to address and control the complications of type 2 diabetes in adult patients) are gaining traction in the sphere of medication.
Influence of incretin
Dr. Yashaswini L S, senior consultant physician and diabetologist at Bangalore Hospital (Jayanagar Branch), explains that “incretins are hormones released from the small intestine, which play an important role in regulating the blood sugar levels. They stimulate the spurt of insulin from pancreas in response to oral glucose intake. The two main incretin hormones are GLP-1 and GIP.”
Admitting that incretin plays a significant part in weight management, Dr Vijay Negalur, HoD of diabetology at KIMS Hospitals in Thane, elaborates in detail: “Incretin performs two actions: the intestinal and central. In the former, it delays the emptying of the GI tract owing to which, satiation occurs. So, the patient loses the desire to eat because the stomach always feels full. The latter function comes from the hypothalamus, which contains specialised neurons in its arcuate nuclei called POMC (pro-opiomelanocortin), signalling not to eat food. When you stimulate this particular neuron in the brain, the patient does not have the craving for food or a feeling of hunger. Therefore, they consume fewer calories than they would have otherwise.”
The therapy
The GLP receptor agonist combines GLP (Glucagon-like peptide-1) with GIP (Glucose-dependent insulinotropic polypeptide) as a dual agonist, while the triple agonist comprises GLP, GIP and glucagon. The second combo of big three alike the double agonist is also available for the hormone treatment and all its drugs are injectable, except semaglutide, which is obtained as an oral tablet.
Involving GLP-1 receptor agonists like semaglutide, exenatide, liraglutide and tirzepatide, incretin hormone therapy is provided in the form of injections and pill ingestion. “These drugs are used in treating type 2 diabetes mellitus and obesity. They have multiple beneficial effects like curtailing appetite, promoting weight decrease, providing cardio protection, declining blood pressure, trimming liver fat, rendering renal safeguard with minimal risk of hypoglycemia and so on,” informs Dr Yashaswini.
Side effects
Incretins can be used for non-diabetic obese individuals, too. “Nausea, vomiting, diarrhoea, constipation are the most common side effects observed in incretin therapies. Also, gallbladder disorders like gallstones and fatigue can be witnessed in some people but thankfully these are all mild and temporary reactions, and usually resolve with time. Most acute side effects are less frequent but can include pancreatitis and an increased risk of medullary carcinoma of thyroid. Besides, Ozempic face can be noticed where the facial skin sags and wrinkles,” apprises Dr Yashaswini.
Among a slew of side effects, GI upset is the most common. “Most of these GI symptoms occur initially and are usually moderate. You need to augment the dose gradually to minimise or mitigate the side effects. Some patients do not opt for these medications due to their GI intolerance,” states Dr Negalur.
Doctor’s directive
It is important to know whether people should purchase and ingest incretin tablets or infuse incretin injections randomly without a specialist doctor’s diagnosis and consultation. How harmful could this approach be?
“No, definitely this isn’t recommended. The doctor before prescribing medicines always evaluates the patient’s detailed history, does a thorough clinical analysis and conducts certain blood investigations. Insulin pills are available in the Indian market with prescription of a registered medical practitioner,” Dr Yashaswini lays the record straight.
Some of the incretin pills can be sourced from the market after being FDA approved. The following drugs obtained the FDA nod:
Semaglutide Injection (Ozempic): approved for type 2 diabetes mellitus, obesity.
Oral Semaglutide Tablets (Rybelsus): approved for type 2 DM.
Liraglutide (Saxenda, Victoza): approved for type 2 diabetes mellitus, obesity.
Tirzepatide (Mounjaro, Zepbound): can be used for treating type 2 diabetes mellitus, obesity.
FACTOID
The term incretin was coined by physician La Barry way back in 1932. It means intestinal discharge of insulin and alludes to nothing but the gut hormones, namely GLP-1 (Glucagon-like peptide-1) and GIP (Glucose-dependent insulinotropic polypeptide).
