Pioglitazone and Semaglutide—two names that may ring a bell, especially if you’re managing Type 2 Diabetes Mellitus (T2DM). Despite their significant generational gap, these drugs share striking similarities and deserve careful consideration before incorporation into your treatment regimen.
Both Pioglitazone and Semaglutide are specifically designed to address T2DM, offering once-daily dosing due to their long-acting nature. However, alongside their therapeutic benefits, they both harbor potential side effects of considerable concern.
Pioglitazone the wonder drug for Ty 2 Diabetes and how it works
Pioglitazone, introduced to the Western market following USFDA approval in the late 1990s, initially garnered attention for its ability to alleviate insulin resistance, thereby enhancing insulin utilization by muscles and fat cells.
The Hard Truth
However, a pivotal revelation emerged in 2012 after a comprehensive analysis spanning 13 years, unveiling a significant association between Pioglitazone use and an elevated risk of bladder cancer. Consequently, regulatory actions ensued, with countries like France and Germany opting to ban its usage completely.
The Sad Truth
Despite these restrictions, pioglitazone remains available in certain regions, including India, where its ban was revoked. Unfortunately, its availability in fixed-dose combination formulations with short-acting Metformin and long-acting Glimepiride, administered twice daily , prescribed by some clinicians, raises concerns about rational prescribing practices.
BlockBuster Sema Glutide OR Diabolique Semaglutide
Semaglutide, on the other hand, represents a newer entrant in the T2DM treatment strategies .Popularly sold under the brand names Ozempic and Rybelsus for diabetes. For weight loss, it is sold as Wegovy. The drug can be taken orally or administered subcutaneously with an injection.
Interesting insights into how Semaglutide works
For nearly four years, it was thought that the drug molecules latch themselves to receptors in the gut or intestine. Turns out, it might actually be doing so in our brains. Semaglutide molecule mimics the Glucagon-like peptide-1 (GLP-1) hormone released by the gut after eating, which attaches itself to GLP-1 receptors located in the gut and brain. The activated receptors help reduce blood sugar and curb appetite, besides preventing release of carbohydrates stored in the liver and production of glucose in the body. Semaglutide lasts in the blood longer than the natural GLP-1 molecule; GLP-1 disappears in minutes, but Semaglutide can stay in the body for up to five weeks, indicates research.
Studies of Semaglutide on genetically engineered rodents / rats with GLP-1 receptors and without GLP-1 receptors in their brains, revealed startling results. In Genetically engineered rodents where the GLP-1 receptors were intact in the brain, the drug not only suppressed appetite for food but caused deaddiction in these rodents which were exposed and addicted to alcohol and cocaine. And in the genetically engineered rodents without GLP-1 receptors in their brains revealed the drug never worked or had any positive effects .
The Lesser known Side effects of Semaglutide
However, like its predecessor, it’s not without its caveats. While research underscores its efficacy, caution is warranted due to emerging concerns about its side effect profile for its use beyond 18 months, particularly its association with Medullary Carcinoma Of The Thyroid (MCT) in Rodents, a rare yet clinically challenging form of thyroid cancer in humans .
Screening For MCT
For individuals with T2DM undergoing Semaglutide therapy, regular monitoring of 1.Serum calcitonin, 2.Serum serotonin (5-HT), and 3.Serum adrenocorticotropic hormone (ACTH) levels is paramount to early detection and mitigation of potential adverse effects.
Is Semaglutide For Everybody
Its use is absolutely prohibited in people with history of Thyroid Cancer. The Latest Cousins of Semaglutide being – 1. Tizepatide (Zepbound / Mounjaro) 2. Amycretin 3.Maridebart Cafraglutide (Maritide)
In conclusion, while pioglitazone and Semaglutide offer therapeutic promise in managing T2DM, it’s imperative to approach their utilization with caution. Awareness of their potential risks and vigilant monitoring are essential components of responsible prescribing practices, ensuring optimal therapeutic outcomes while safeguarding patient well-being. Before embarking on any treatment regimen involving these medications, engage in a comprehensive discussion with your healthcare provider to assess the risks and benefits in the context of your individual health profile and treatment goals. Your well-being is paramount—be informed, be vigilant, and be proactive with selfcare.
