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So many Acronyms!

Weight loss measuring tape wrapped around a fork with yellow background

There are so many acronyms in science and particularly the field of medicine. I just wanted to go over a couple with regards to weight loss medication.

So, what is the difference between a GLP1-agonist and a DPP-4 Inhibitor, and how do they compare with regards to weight loss?

On our weight loss course, we teach you all about the GLP-1 agonists. We do mention DPP-4. But it is not a major component. Here I just wanted to provide you with some extra information around the subject.

Glucagon-like Peptide 1 (GLP-1) is an incretin hormone.

It is released in the gut in response to increases in glucose from the diet.

It causes an increase in insulin and a decrease in Glucagon.

The increase in insulin pushes the glucose into our cells for use as an energy source and hence reduces blood sugar. (Glucagon has the opposite effect, which is blocked GLP-1).

Diabetics may have an impaired response to GLP-1 and hence their blood sugar rises.

As discussed earlier the GLP-1 hormone is only released in response to rises in glucose e.g., from a meal. GLP-1 has a natural life of a few minutes in the body. The main reason for this is that GLP-1 is quickly broken down by the enzyme dipeptidyl peptidase-4 (DPP-4).

The class of drugs known as the DPP-4 inhibitors block the breakdown of natural GLP-1. Thus, prolonging its action.

So how do the two compare in terms of weight loss and other associated health outcomes.

Gilbert and Pratley have compared the two agents (2020)

GLP-1 agonists can lead to a weight loss. That’s why we use them in this way. They also have cardi-protective actions. On the negative side they can lead to stomach discomfort. Hence, we titrate the dose upwards. They also lead to better glycaemic control.

The DPP-4 inhibitors like the GLP-1 agonists are indicated in type 2 diabetes. However, they are weight neutral, so are not used in weight loss programs. They do not have the cardio-protective action of the GLP-1 agonists. However, they do not cause the gastro discomfort of the GLP-1 agonists.

Note: the name Glucagon Like Peptide 1 comes from the structure of GLP-1 not the action – which is to reduce glucagon

If you want me to cover any other topics related to weight loss or the GLP-1 agonists, please leave a comment or email the team at MJ Clinical Training Ltd.

Matthew P. Gilbert and Richard E Pratley.

GLP-1 Agonists and DPP-4 Inbitors in Type 2 Diabetes Therapy: Review of Head-to-Head clinical trials. April 2020.

https://pubmed.ncbi.nlm.nih.gov/32308645

Semaglutide (Wegovy) vs. Tirzepatide (Mounjaro): Which is the Better Weight Loss Medication? 

There are no direct head-to-head trials between semaglutide (Wegovy) and tirzepatide (Mounjaro). So, what we have to date is like comparing two world-class boxers and asking who is the best, when they have never actually fought each other. This study uses statistical analysis to virtually “match” and “pair-up” participants in different trials to provide a better comparison of the effectiveness of the two drugs.

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