Browse the evidence

Intensive blood pressure control (Systolic < 120 mmHg) in Type 2 Diabetes does not reduce major cardiovascular events compared to standard control (< 140 mmHg) and increases adverse events like hypotension and renal failure.

For Type 2 Diabetics with high blood pressure, aiming for a standard target (e.g., <140/90 mmHg) is likely sufficient for preventing major heart events and avoids the risks of side effects like fainting or kidney stress associated with very aggressive lowering (<120 mmHg). Consult your doctor for a personalized target based on age and comorbidities.

SGLT2 inhibitors and GLP-1 receptor agonists reduce hospitalization for heart failure, chronic kidney disease, and atherosclerotic cardiovascular disease in patients with type 2 diabetes.

If you have type 2 diabetes and heart or kidney issues, ask your doctor about SGLT2 inhibitors or GLP-1 RAs. These drugs do more than lower blood sugar; they protect your heart and kidneys, reducing the risk of hospitalization and death.

GLP-1 receptor agonists provide renoprotective effects by slowing eGFR decline and reducing albuminuria in patients with type 2 diabetes and chronic kidney disease.

If you have diabetes and kidney issues, GLP-1 medications can help protect your kidneys and heart, not just your blood sugar. This protection happens through multiple mechanisms, including reducing inflammation and improving blood flow to the kidneys. However, gastrointestinal side effects are common and may require dose adjustments or management strategies.

Tirzepatide sensitizes leptin signaling in hypothalamic POMC and GLP-1R neurons, increasing POMC neuronal firing by decreasing inhibitory postsynaptic input.

Tirzepatide works in part by making your brain's natural weight-regulating hormones more effective. This leads to reduced hunger and increased energy expenditure, contributing to weight loss.

Discontinuation of incretin-based pharmacotherapy (GLP-1 or dual GLP-1/GIP agonists) leads to partial or complete weight regain due to the reactivation of homeostatic neurohormonal systems (increased ghrelin, decreased leptin and peptide YY), confirming obesity as a chronic condition requiring long-term management.

If you stop taking your incretin medication (like semaglutide or tirzepatide), your body's natural hunger signals will likely return, causing you to regain the weight you lost. This is a biological response, not a lack of willpower. To keep the weight off, you must treat obesity as a chronic condition and continue your medication and lifestyle habits long-term, just as you would for high blood pressure.

GLP-1 receptor agonists improve cardiovascular outcomes in patients with atherosclerotic cardiovascular disease (ASCVD) and heart failure with preserved ejection fraction (HFpEF), but may increase heart failure hospitalization risk in patients with heart failure with reduced ejection fraction (HFrEF).

If you have heart disease or heart failure, GLP-1 RAs can significantly reduce your risk of major cardiovascular events like heart attack or stroke, especially if you have HFpEF. However, if you have HFrEF (reduced ejection fraction), these drugs may increase your risk of hospitalization, so your doctor will need to carefully weigh the risks and benefits.

Retatrutide has the highest adverse event risk among the treatments studied.

Clinicians should be aware of the higher risk of adverse events when prescribing retatrutide.

The risk of gastrointestinal adverse events was higher among semaglutide participants than placebo.

Clinicians should monitor for gastrointestinal side effects in patients using semaglutide, although most are manageable.

Tirzepatide and GLP-1 RA across all doses had significant increases in gastrointestinal adverse effects compared to placebo.

Clinicians should monitor gastrointestinal side effects in patients treated with tirzepatide and GLP-1 RA.

Use of GLP-1 receptor agonists (GLP-1 RAs) is associated with an increased risk of gallbladder or biliary diseases (RR, 1.37; 95% CI, 1.23-1.52).

Healthcare providers should be aware of the potential increased risk of gallbladder diseases when prescribing GLP-1 RAs.

GLP-1 RA use is associated with a higher risk of gallbladder or biliary diseases at higher doses (RR, 1.56; 95% CI, 1.36-1.78) compared to lower doses (RR, 0.99; 95% CI, 0.73-1.33).

Dosing strategies for GLP-1 RAs should consider the potential increased risk of gallbladder diseases.

Obesity is a major contributor to primary hypertension through mechanisms such as neurohormonal activation, inflammation, and kidney dysfunction.

Addressing obesity is crucial for managing hypertension risk.

One-year discontinuation was significantly higher for patients without type 2 diabetes (64.8%) compared with those with type 2 diabetes (46.5%).

Practitioners should be aware that patients without type 2 diabetes may struggle more with adherence to GLP-1 RA therapy.

Ozempic users increased from 569 in 2019 to 7667 in 2020, with a count of 22,891 in 2022.

Practitioners should be aware of the rapid increase in Ozempic usage, indicating its growing acceptance and demand.

Adverse events were more frequent with liraglutide, with 80% of participants experiencing gastrointestinal events compared to 57% with placebo.

Clinicians should monitor for gastrointestinal side effects when prescribing liraglutide.

Acute RT-induced hormonal elevations seem not to be directly correlated with muscle growth.

Practitioners should be cautious in assuming that increased hormonal levels from acute training will directly lead to muscle growth.

Pioglitazone and GLP-1 receptor agonists are promising treatments for NAFLD that also benefit the vasculature.

Clinicians may consider these medications for managing NAFLD and associated cardiovascular risks.

Plasma TMAO, carnitine, crotonobetaine, and γ-butyrobetaine concentrations were positively associated with fasting insulin level.

Higher levels of these metabolites may indicate increased fasting insulin levels, which could inform dietary or lifestyle interventions.

GLP-1 analogs may interact with estrogens.

Consideration of estrogen interactions may be important in treatment plans involving GLP-1 analogs.

69,213,936 prescriptions for obesity medications (OMDs) were dispensed in the US from July 2017 to February 2024, with a mean annual growth rate of 5.3%.

Healthcare providers should be aware of the increasing trend in OMD prescriptions.

There is a lack of consensus on whether the menstrual phase and associated changes in sex hormones allow broad application of nutrition principles to female athletes.

Nutrition guidelines may need to be tailored for female athletes considering hormonal influences.

Pre-operative semaglutide use within 10 days of elective surgical procedures was independently associated with increased risk of residual gastric content on pre-operative gastric ultrasound assessment.

Practitioners should consider the timing of semaglutide administration in relation to elective surgeries to mitigate the risk of increased residual gastric content.

Semaglutide treatment resulted in lower rates of non-CV death, primarily due to fewer infectious deaths (HR: 0.71; 95% CI: 0.51-0.98).

Reducing infectious deaths may be a significant benefit of semaglutide in this population.

Among participants who developed COVID-19, those treated with semaglutide had fewer COVID-19-related serious adverse events and deaths (HR: 0.66; 95% CI: 0.44-0.96).

Semaglutide may provide protective benefits against severe outcomes from COVID-19 in this population.