Semaglutide, tirzepatide, and dulaglutide achieve similar results and have similar mechanisms of action, so the choice often comes down to preference and tolerability.
Glucagon-like peptide-1 receptor agonists (GLP-1) medications are used to treat patients with type 2 diabetes and obesity. GLP-1 medications such as semaglutide, tirzepatide, and dulaglutide help control blood glucose and appetite. The newest of the three is tirzepatide, approved by the FDA in 2023. Its notable difference is that it works on both GLP-1 and glucose dependent insulinotropic polypeptide receptors (GIP).
Research shows that semaglutide, tirzepatide, and dulaglutide are each efficacious in lowering HbA1c and body weight, and the newer once-weekly injectable tirzepatide has shown similar weight loss results as semaglutide. The SOURMOUNT-1 trial, however, found that reduction in baseline weight of 15 percent, 19.5 percent, and 20 percent at 72 weeks with the 5mg, 10mg, and 15mg doses of tirzepatide surpassed the performance of semaglutide; it’s also reported that tirzepatide resulted in greater weight loss than dulaglutide, which is good news for patients because of its recent FDA approval for weight loss.
Because semaglutide, tirzepatide, and dulaglutide produce similar results in the context of type 2 diabetes and weight loss, the choice regarding which medication to prescribe comes down to preference, patient tolerance, cost, administration (oral or injectable), and patient responsiveness. For a general overview of each medication contact the BioDezyne Center of Victoria, LLC.
Implications for Clinical Practice: GLP-1s as Adjuncts to Diet and Exercise
Commonly reported side effects of GLP-1 medications include gastrointestinal events such as bloating, nausea, vomiting, and diarrhea. To offset the side effects and to ensure nutritional needs are being met, supplementing patients’ diets with nutritionally designed meal replacements for patients prescribed GLP-1 medications warrants consideration. Supplementing patients’ diets with nutritionally designed meal replacements can help patients ensure they are consuming the RDA for vitamins, minerals, protein, and fiber while also helping them manage the GI side effects of GLP-1 medications.
In addition to the GI side effects, patients can lose muscle mass quickly when food consumption is reduced. Loss of lean muscle mass can adversely affect major organs of the body; most importantly, muscle is metabolically active, requiring energy to sustain itself. When one has more lean mass, their resting metabolic rate is increased, which translates into an increase in the number of calories being burned. In short, more lean mass results in higher energy expenditure because of the increased metabolic rate.
To ensure nutritional needs are being met, pre-packaged, nutritionally designed shakes/beverages offer convenience and satisfy daily recommendations for vitamins and minerals. Nutritionally designed shakes/beverages have the added benefit of reducing GI side effects and should be considered as part of patients eating healthy plan while on weight loss medications.