In the news

Wither goest Ozempic?

            Ozempic and Wegovy, made by the same company, are the trade names of the GLP-1 drugs known as semaglutides. Although they are chemically identical, the dosage, the packaging and their intended uses are different. Such is the way of marketing!

            These medications are intended to improve the health of obese, diabetic persons. They have several actions, including decreasing the appetite, providing a feeling of fullness, slowing digestion, decreasing glucose production in the liver and increasing the release of insulin. Ozempic is intended to slow the progress of type 2 diabetes while Wegovy is designed to aid in weight management, i.e., weight loss. 

            In clinical trials they were helpful in managing both problems, although the regimen used also included reducing calories and increasing physical activity, fundamental measures in any weight loss program.

            Patients taking Wegovy lost 15 percent of their body weight in a 16-month trial period. Those taking Ozempic lost 7 percent. If we can assume that the average weight of the participants was approximately 225 pounds, both groups would still have been overweight or obese at the end of the trial. To be sure, even such modest weight loss is beneficial in managing type 2 diabetes and in lowering the risk of cardiovascular disease. In fact, among study subjects, those taking these drugs showed a significant decrease in cardiovascular disease, and in slowing of the progression of kidney disease.

            Is this the best solution to the national epidemics of obesity (42 percent) and type 2 diabetes (12 percent). Consider the following challenges.

            The cost of Ozempic is nearly $1000 per month; Wegovy costs about $1350. Few patients will pay that much because of insurance, or pricing plans offered by the company.

            This is a weekly injection, not a pill. Side effects are not common, most being in the range of ten percent or less, including nausea, vomiting, diarrhea and constipation. Infrequent but serious side effects include inflammation of the pancreas and gallbladder; allergies, temporary hair loss, vision problems and mood changes have been reported.

            Losing weight is frustratingly difficult, as most overweight persons are aware. Drugs are convenient; lifestyle changes are not. Some of the current generation of weight-challenged persons may find some success with prescription drugs. The long-term hope is that coming generations will be encouraged to avoid excess weight gain in the first place, but that will probably require draconian governmental intervention. The combined cost of obesity and diabetes is more than a half-trillion dollars annually. I’ll discuss what might be a real solution in a coming post.

Lifestyle

Preventing falls: things we overlook

            Falls, especially among the older generation, are a serious problem, often resulting in death. The frailty that accompanies aging is only part of the problem and one that can be postponed for decades if we are committed to a lifetime of regular, moderately intense physical activity. In addition, there are some steps, especially as we get older, that will lower our risk.

            How safe is your flooring? Secure or remove loose rugs.

            Some shoes don’t belong in your wardrobe. Get rid of those that are too slippery (smooth leather soles) or too clingy (crepe soles).

            Bare feet and socks increase the risk of falls.

            Improve lighting with night lights and lighting strips. They are cheap insurance.

            Move frequently used kitchen items to a lower shelf. And never stand on a chair!

            If you wear bifocals or transitional lenses you just might have to move more deliberately.

            Face it! You can’t hold your liquor like you did at 20. Adjust.

            On a new medication? Be extra careful. Some cause dizziness.

            It’s worth getting a consultation on fall prevention from an occupational therapist. Discuss this with your physician. Things like grab bars in the shower can be literal lifesavers. And they increase resale value!