The efficacy and safety of the new GLP-1 medicines continues to garner interest and will be discussed
#ADA2024
Here is an updated safety-focused summary of the field and where it might be headed
@DiabetesCareADA
#T2D
#obesity
2018 accomplishments
1)Most of our knockouts had no meaningful phenotypes
2) When we increased (n) statistical significance usually disappeared
3) Many of my hypotheses flat out wrong
4)Trainees rescued me almost every time
5)Valued truth over hyperbole
Postdoc position pls R/T-help us figure out gut hormone action-you don't have to be highly motivated, or brilliant-we aren't any of those things either. Curiosity, high ethical standards, thoughtfulness, a flair for generating reproducible (negative) results, that's how we roll
As GLP-1 medicines evolve to target more receptors beyond the GLP-1R, ideally exhibiting enhanced efficacy, new questions arise about long term safety. Mechanistic and outcome studies will help define the value proposition for each NCE in the clinic
The most effective medical therapy developed to date for
#obesity
the GLP-1R Agonist Semaglutide 2.4mg once weekly (Wegovy) now approved in the USA
@US_FDA
@novonordisk
There are now hundreds of authoritative experts that opine daily on the risk of GLP-1 therapies, often scaring people about the risk
#pancreatitis
Yet after 18 years in the clinic for
#T2D
there is no signal for pancreatitis in RCTs or real world data
With GLP-1 as your peptide backbone the world of metabolism beckons.
@LillyDiabetes
@LillyPad
presents new data for 1) Once weekly oxyntomodulin & 2) The triple GLP1R-GCGR-GIPR agonist in people with
#T2D
Bariatric surgery-like weight loss with GLP-1 medicines is coming
#obesity
The gut brain
#microbiota
axis via the vagus nerve defined via commensal bacterial translocation to the mouse brain and microglial activation in models of diverse neurological diseases
I am priveleged to know and learn from dozens of outstanding female colleagues in cardiology and diabetes, all world experts. Here we have a wonderful meeting, 39 men on the Scientific Committee 0 Women
#Manels
Lets do better, its 2020
@picardonhealth
The most effective GLP-1-based medicine to date, Tirzepatide, approved by
@US_FDA
for treatment of people living with
#obesity
and weight management, marketed as Zepbound, by
@EliLillyandCo
2.5-15mg doses, 20% less expensive than 2.4 semaglutide ow
GLP-1-based therapies are slowly approaching
#bariatricsurgery
level
#weightloss
and more exciting science to come. There is the impressive SURMOUNT-1 trial for tirzepatide
#obesity
First oral semaglutide made a strong impression in OASIS-1
#obesity
with 15%
#weightloss
now orforglipron leads the impressive pack of new small molecule oral GLP-1RA with robust
#Weightloss
and good tolerability ADA2023
Finally, we know how
#metformin
works, in the gut to increase basolateral intestinal glucose uptake (BIGU) and via gut liver cross talk to reduce hepatic glucose production
@PNASNews
#diabetes
Just some of the fascinating insights that rocked the GLP-1 incretin world this week-a glimpse of top line data for AMG-133 the GIPR Antagonist-GLP1R Agonist antibody. One dose every 4 weeks for 12 weeks, total of 3 doses, 14.5%
#weightloss
We never know what we don't know
@Amgen
Lots of interest in muscle loss, quality and strength after
#weightloss
with GLP-1-based therapies. Here Tirzepatide reduces the fat content of muscle, with modest changes in muscle volume
#EASD2023
@EASDnews
As we recognize collective scientific achievements we must continually re-invest in our students, trainees and new scientists as they establish their own careers. Supporting their success will provide unanticipated novel solutions ensuring the health and prosperity of all nations
Congratulations to Canada’s own Dr.
@DanielJDrucker
and Dr.
@EAEisenhauer
on this well-deserved recognition. Through your research and your leadership, you represent the very best of our country and make our world a better and healthier place - thank you.
#GairdnerAwards
GLP-1 medicines started with injectable GLP-1RAs, then moved to oral peptides, and now co-agonists. The future will usher in multiple new ways of delivering GLP-1 medicines, and activating GLP-1R signaling pathways, promising improved efficacy/convenience.
Random
#COVID
ー19 musing. Ok, you are smart. However your PhD in nutrition, biochemistry, cancer biology, neuroscience, or your medical expertise in a medical specialty does not make you qualified to opine on a new virus you know nothing about. Bottle the narcissism. Stay silent
The scientific community is thrilled to acknowledge the appointment of Professor Anne-Claude Gingras, a global expert in proteomics and systems biology, as the new Director of the Lunenfeld-Tanenbaum Research Institute
@SinaiHealth
@uoftmedicine
@UofT
@gingraslab1
@uoftmedgen
GLP-1 medicines produce adverse events, predominantly gastrointestinal, transient in most. Yet controversy continues surrounding what AEs are rare but real vs. alleged but not rigorously proven in RCTs or real world data. Free to read
@DiabetesCareADA
This week, we celebrated my moms 93 birthday. On April 8, Yom Hashoah, we commemorate millions of innocent people slaughtered during World War 2, including my grandmother and aunt, shown here, and dozens of family members who perished. Evil is enabled when you look the other way
Cold shower for the
#microbiome
crowd. "95% of published studies on HMA rodents reported transfer of pathological phenotypes to recipient animals. We posit that this exceedingly high rate of inter-species transferable pathologies is implausible" Indeed
Metformin discovered in 1922, was introduced as a drug for
#diabetes
in 1957. Within the last 18 months we have many "definitive" mechanistic studies in mice, rats and humans, acute & chronic dosing, showing how metformin lowers glucose. Yet most of them are largely contradictory
Losing weight vs. sustaining
#weightloss
Data suggest that weight loss vs. weight loss maintenance are physiologically and psychologically different in many ways
@NatMetabolism
#obesity
Astonishing, did we all not realize that people with hypertension, high cholesterol, inflammatory bowel diseases, all kinds of chronic inflammatory arthritis, CLL, CML, hypothyroidism (I could go on) relapse with discontinuation of medicines? We need to recalibrate our mindsets
Scientists are under pressure to repeatedly produce highly novel data that fundamentally shifts understanding of current concepts. Is this realistic? Does it prompt us to stretch the truth in our relentless search for innovation/novelty? How often are stories too good to be true?
The authors present 74 key genes for
#obesity
, which are highly interconnected and enriched in several biological processes that contribute to obesity, including energy expenditure and homeostasis.
#Genetics
As the magnitude of
#weightloss
achieved w GLP-1-based medicines continues to increase, more attention has shifted to "quality" of weight loss, preservation of lean mass and muscle strength, with consideration of sarcopenic
#obesity
Yet to date, physical activity improves in most
“We suggest that although
#insulin
plays an important role in body fat regulation, the CIM fails because it focuses on the direct action of insulin on adipose tissue after the consumption of a meal containing carbohydrates”
@KevinH_PhD
@JohnSpeakman4
Old fashioned physiology, small data, non-automated, often tedious, & rarely sexy, has fallen out of favour, with shiny modern massive OMICs enjoying the limelight. One minor problem. For drug discovery, physiology is essential for target validation, therapeutic efficacy & safety
@DShaywitz
@nntaleb
Big data does not necessarily provide insight into physiology. Need that for targeting pathways. Think GLP1, SGLT2i. Big data help?
SGLT2 identified as a regulator of cell surface PD-L1 degradation, revealing a potential therapeutic target using SGLt2i to overcome immune evasion by tumor cells
@jclinicalinvest
Metabolically Healthy
#Obesity
Is it a real thing, or a transient stop on the way to more serious disorders? The 2023 Burrow Lecture, Professor Sam Klein, Friday September 29, 8 am live and virtual
@uoftmedicine
@BBDC_UofT
@physiologyuoft
After the most traumatic and deadly day for Jews in a generation, the leaders of most Canadian and international academic institutions, home to tens of thousands of Jewish students and faculty, had absolutely nothing to say. The silence in the face of moral depravity is deafening
Semaglutide first (20 wks) then addition of aerobic exercise (12 wks) in people with
#T2D
= substantial weight loss (8.9kg) maintenance of lean mass, increased
#insulin
AUC and C-peptide, improved insulin sensitivity
No one chooses their parents or country of birth. My parents endured horrors beyond belief, survived, and traveled across continents in search of a new life in a democratic tolerant country 🇨🇦 welcomed them 65 years ago. Not a day that I am not thankful. Happy Birthday Canada
As some of you congregate
#ADA2024
that occasional reminder that health and life are precious and should never be taken for granted. Hug your colleagues, kiss your kids, call your parents. Take that vacation. George Bakris and David Wasserman, gone far too soon 💔
The anti-
#cancer
effects of calorie restriction but not
#intermittent
fasting are mediated by the gut
#microbiota
B. bifidum, acetate production & accumulation of interferon-γ+CD8+ T cells in the tumour microenvironment in female mice
@NatMetabolism
GLP-1….. who knew? Never touted as very fancy, papers usually eschewed by top Journals for lack of definitive mechanism, yet science published in subspecialty Journals was highly reproducible, from mice to humans, 🇨🇦 to 🇩🇰. Don’t underestimate careful basic and clinical science
I wrote about the new anti-obesity drugs—semaglutide (Wegovy) and tirzepatide (Mounjaro)—that represent one of the most important breakthroughs in medicine
My late father Ernest, of blessed memory, would have been 100 today. He joined the British army Czech brigade, was wounded in
Tobruk, and managed to restart a new life in the fledgling state of
Israel. Dad would be shocked to see how
#antisemitism
remains a scourge amongst us
Based on fascinating animal data “in
#T2D
the defended level of blood glucose can be restored to normal by therapies that restore the brain’s ability to properly sense the circulating glucose level”
@DiabetologiaJnl
GLP-1 and GIP are physiologically essential for suppression of
#inflammation
and pharmacologically suppress inflammation, actions potentially relevant to reduction of complications
#T2D
How and where do incretins instruct the immune system?
GLP-1R agonists powerfully suppress gut chylomicron secretion, actions we don’t routinely measure in the clinic with fasting lipids. Does this mechanism contribute to reduction of
#atherosclerosis
and
#MACE
#heartdisease
@DiabetologiaJnl
Suggestion. Before you launch your press release, think of all the real people and families battling the disease you targeted in your organoids and mice. Many are truly desperate for real progress now, not in 5 years. Now read your press release again, and look hard in the mirror
"Exaggerated reporting of science runs the risk of creating a perpetual attitude of distrust in science that is harmful to science, researchers and society."
"university press releases read like news articles, describing a discovery in engaging language"
With SURMOUNT-2 results imminent, there will soon be H2H trials of Semaglutide 2.4mg vs. Tirzepatide, and likely Cagri-Sema vs. Tirzepatide
#Obesity
#T2D
@LillyPad
@novonordisk
As discussed most of our GLP-1 findings over the years were rejected by "high impact" Journals. This paper describing GLP-1 inhibition of apoptosis is now featured
@jbiolchem
after 700+ citations. Don't let glam Journals define you
The new powerful GLP-1 medicines at doses used for
#obesity
are relatively new. Yet the class of GLP-1 medicines is now 19 years old, with Exenatide approved for
#T2D
April 28 2005. We have millions of treatment years for this class. Happy birthday Exenatide/GLP-1 medicines!
Development of novel flourescent glucose sensors for rapid, high-resolution live imaging of glucose influx, efflux, and metabolism in animals
@CellReports
After decades of gut
#microbiota
#obesity
research➡️A mechanistic linkage between gut commensals and obesity through the overproduction of microbe-derived lipids impairing intestinal epithelial integrity to promote metabolic endotoxemia
@Cell_Metabolism
In 2021 after the cells are all singly sequenced, OMICs fully completed, and circuits fired up and down with opto and chemogenetics, folks will rediscover the forgotten old wizards of systems physiology and ask “So how does this biological system actually work?”
Few journalists write articles describing return of disease symptoms after stopping dozens of different medicines for chronic disorders, cause folks would say “Really? What did you expect?” So why the ‘surprise/fuss about
#obesity
and
#weightloss
medicines
18 years ago, I was sitting in a bar in La Jolla with Amylin Pharma colleagues, waiting for the NDA approval for the worlds first GLP-1 receptor agonist, exenatide twice daily, for
#T2D
Amazingly, the story has expanded in ways few could have imagined. Support
#science
#research
Notable that so many social justice warriors, including scientists, rushed to insert
#BlackLivesMatter
or 🇺🇦 flags in your timelines, now have nothing to say publicly as Jews are slaughtered. Please don’t ever again comment about human rights if your morality is so twisted
A rabbi, priest, guru and imam meet to resolve the outstanding questions & problems facing the worlds great religions. Remarkably they find good agreement and a unifying path forward. As they are leaving one of them asks "How do you think metformin works?"
Saxenda® (liraglutide)
@novonordisk
injection 3 mg daily becomes the first
@US_FDA
-approved therapy to treat
#obesity
in adolescents in more than a decade Updated prescribing label issued in USA