Health matters newsletter: The whole truth about weight-loss drugs
On 'weight loss' drugs and their impacts, the scorching heat and sleep apnoea, what persists after a Covid-19 infection, AI in healthcare, and more.
Universally, a certain class of drugs have come to be superstars in recent times. The GLP-1 class of drugs, with their capacity for weight loss, though originally conceived and developed for diabetes, has suddenly become the toast of the season, for one reason - their weight loss properties. With celebrities like Elon Musk flaunting their use of these drugs, semaglutide and more recently, tirzepatide, reached homes even before the results of rigorous control trials were ready for publication. While over the months, the trials have indicated good overall results, both for weight loss and blood sugar control, a new field study offers a more realistic estimate of how these GLP-1 receptor agonists work in real time.
A recent study, done in the U.S. indicated that these New 'weight-loss' drugs have lower impact in real life compared to clinical trial results. In a paper published in the journal Obesity, Hamlet Gasoyan et al accessed electronic health record data from a large health system in Ohio and Florida to identify adults with overweight or obesity without type 2 diabetes who started with injectable semaglutide or tirzepatide between 2021 and 2023. The researchers observed that treatment discontinuation and use of lower maintenance dosages might reduce the likelihood of achieving clinically-meaningful weight reduction in patients on these drugs.
This is something that diabetologists in India agreed with, instinctively. In a randomised control trial, there is incentive and constant reminders to take the drugs. In the real world setting, when patients have to pay for their drugs out of their own pocket and without a rigorous reminder, or because of the side effects that they cannot tolerate, a number of people discontinue treatment. And drugs work only as long as they are taken.
Further on this topic, Dr. V. Mohan, Chennai-based diabetologist discusses on The Health Wrap by The Hindu about who are ideal candidates for these drugs, whether a regimen must be followed and deciding the appropriate dosage levels for people on GLP-1 drugs. Zubeda Hamid and I discuss other issues too, including good and bad bacteria, migration and climate change, not to mention a giraffe's cervical structure. Do tune in, to listen.
Having lived out another May, a torrid summer, there is no doubt that a climate crisis is upon us. The WHO says 2024 was the warmest year on record – but the heat is far from over. A new report from the World Meteorological Organization (WMO) warns that global temperatures will likely continue rising, with an 80 per cent chance that at least one year between now and 2029 will be even hotter. Climate emergency is a health crisis 'that is already killing us,' the WHO adds.
Delhi and other parts of northern and central India were severely impacted as temperatures soared beyond bearable. Our stories give you a clear picture: Delhi under 'red alert' as mercury soars beyond 45 degrees C; severe heatwave conditions to persist; Blistering heat continues in north, central India; hills scorch. Meanwhile, we also reported on a study which found that Warmer climate could make sleep apnoea more severe, common. Sleep apnoea, a condition characterised by having trouble breathing properly while sleeping, could become more common and severe in a warmer future, a new study has found. Obstructive Sleep Apnoea (OSA) is a common sleep disorder, estimated to affect about a billion worldwide. The condition occurs when muscles in the throat narrow the airways, impacting breathing and blood oxygen levels during sleep.The findings, published in the journal Nature Communications, show that one's chances of experiencing sleep apnoea could spike by 45 per cent on days with higher temperatures.
Meanwhile, the government is mulling whether to restrict the temperature range on air conditioners. Vasudevan Mukunth, here, explains the Science behind setting the right temperature on the air conditioner.
Last week, a very important document was launched, something we would do well to heed. With the launch of HelpAge India's national report, ahead of World Elder Abuse Awareness Day, which is marked on June 15, on intergenerational dynamics, it is clear that we need to create better bonds with senior citizens and also encourage more digital literacy. For a greying nation, we need to pay more attention to the health and social support needs of the elderly, bringing it back into the DNA of the culture we live in.
We do our periodic dip stick test for COVID-19, profiling various developments in the area, even as the number of cases is going up slowly. Dr. M.S. Seshadri and Dr. T. Jacob John explain what the current Resurgence of COVID 19 means for India. They argue that the recent number of COVID-19 cases, reported as nearly 7,000, reflects the greater volume of testing, not the true magnitude of infection or disease in the population.
More than four years since the COVID-19 pandemic began, the disease remains a global health concern — not because of new surges but because of what persists. Do read about a genetics study that linked a lung gene to known, recorded post-COVID sequelae. Bindu Shajan Perappadan also focuses on the same angle, reminding readers of the the threat of deep vein thrombosis associated with COVID.
We also endeavour to point out areas of hope and positivity, as it is so important in health care. Health is as much about wellness and recovery as it is about disease and pain. There is some hope with reports that Novavax's COVID-flu combo vaccine which showed strong immune response in trial.
In other news, Jacob Koshy reports that SII and DNDi have partnered to expand human trials for dengue treatment. Hopefully, we will have better dengue treatment protocols soon. Again in India, here is a model that could be replicated, as Rajasthan's cash plus model pushes up early breastfeeding rate, dietary diversity among new mothers.
The big minus about treating cancer is the way the treatment causes general toxicity, as it tars even healthy tissue with the same brush. Here, there seems to be a solution to this: In a first, arc therapy beats tricky cancer while sparing nearby tissue.
Afshan Yasmeen reported that Karnataka's MMR was steadily decline; it has reduced to 58 per lakh live births in 2020-22. Great news, indeed.
It was also the week we discussed India's falling fertility rates. As per a UN report, fertility rate drops below replacement level, Purnima Sah wrote. According to the UNFPA, millions of people in India are not able to realise their real fertility goals. Calling this the 'real' crisis, and not overpopulation or underpopulation, the report calls for the pursuit of reproductive agency — a person's ability to make free and informed choices about sex, contraception and starting a family — in a changing world. Replacement-level fertility, commonly defined as 2.1 births per woman, is the rate at which a population size remains constant from one generation to the next.
The recent World Health Assembly has created a turning point for skin health, explained Dr. Monisha Madhumitha. Here's what the WHA's landmark resolution on skin diseases means for the world.
Moving on to a key component of health care, we had articles that discussed the role of AI in the health sector this past week.
While Sayantan Datta asked How safe AI is in healthcare depends on the humans of healthcare, Dr. Aravinda C. took the argument further discussing the promise and pitfalls of evaluating AI tools with mismatched yardsticks. Dr. V. Viju Wilben turned our attention to how technology can help, at a time when most city roads are perennially clogged with traffic jams, to reclaim the Golden Hour, and save lives.
In the tailpiece segment, reverse ageing steals the spotlight. If only it were possible! But Anirban Mukhopadhyay brought hope, with the article. Common molecule offers clue to making old muscles young again. As we age, it gets harder to recover from a fall, injury or even a tough workout because the body's muscle-repair system starts to falter. Muscle stem cells (MuSCs), the in-house repair crew, stop dividing and rebuilding tissue, losing their ability to respond to damage. A study in Cell Stem Cell on June 12 suggested this decline may be reversible. The key isn't some futuristic therapy but a molecule already used in hospitals today -prostaglandin E2.
We had a very healthy, and robust explainers section this week.
Sophie Davies, in The Conversation wrote of Diverticular disease
Sreedevi Jayachandran explained Tourette syndrome and its management
Serena Josephine M.'s story in our 'All You Need to Know About' series was on hernias
Dr. Steve Thomas wrote two fine pieces on the occasion of blood donation day. Do click on the links to read them: Our body's crimson tide: understanding blood disorders and the vital role of blood donation and Our body's crimson tide: the evolving treatment landscape in haematology
Athira Elssa Johnson wrote on The risks of undiagnosed gall bladder stones: doctors call for awareness, timely treatment, how to read the tongue as a measure of health; and filed yet another story in our monthly Nobel winners series: This one on Sir Ronald Ross and his contributions towards malaria control
Dr. Sathyanarayana L.D. elaborated on a little-explored subject, in connection with Brain Tumour Day (June 8) on aphasia, or the loss of language, after brain tumour surgery.
Our In Focus podcast discussed the risks of the government's proposed 'mixopathy' move
If you have some extra time on your hands, also read:
C. Maya: Living donor transplants thrive as Kerala turns its face away from deceased donor organ donations
Serena Josephine M.: Many private hospitals in T.N. hit by acute shortage of Hepatitis B vaccine
Indian-origin physician Bobby Mukkamala sworn in as American Medical Association president
Science Quiz: On eye health
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