type 2 Diabetes mellitus

Nearly 2/3 of Patients Quit GLP-1 Drugs within the First Year

Robert Cucin MD JD MBA Diabetes, metabolic syndrome, obesity , , ,

In a recent study published in JAMA Network Open, 65% of those without diabetes discontinued their semaglutide drug in less than one year.

The quit rates were not only for cost but for the side effects and complications. Those who trimmed more weight were more likely to persevere with the drugs and those that regained weight after stopping the medications were more likely to pursue a second course.

While health insurers widely cover this class of glucagon-like peptide (GLP-1) agonists for diabetes, most don’t pay for these drugs for weight loss. List prices often exceed $1,000 per month and insurance is spotty. Just 1% of Affordable Care Act marketplace plans last year covered these drugs for obesity according to KFF, a nonprofit health policy organization.

Medicare paid $5.6 Billion for semaglutides in 2022, demonstrating the immensity of the obesity problem.

As reports of complications and side effects of these drugs continue to accumulate as fast as articles on discontinuance rates, it is evident that even though patients prefer pills to surgery, the semaglutides are not miracle drugs. As with every single drug we use OTC or prescribe, a side effect is just really just one of the many effects of any drug other than the desired one. We consider Endoscopic Visceral Lipectomy both complementary to patients taking the GLP-1’s and suitable as an alternate modality to those patients who don’t start or stop taking them.

The Mesentery Gets Recognition

Robert Cucin MD JD MBA bariatric surgery, Diabetes, metabolic syndrome, obesity , ,

The mesentery, that humble peritoneal fold suspending the bowel and providing its blood supply, has finally been recognized as an organ.  Prof J Calvin Coffey and D Peter O’Leary , PhD in a recent article appearing in the Lancet    propose that the mesentery be recognized as an organ in its own right.   We applaud the elevation of the mesentery’s status to the 79th recognized organ in the body.  Recognizing the mesentery as an organ, is important as it allows us to study its effect on maintaining healthy or contributing to diseased states.

We have maintained that the noxious cellular hormones secreted by the mesenteric fat constitute a deadly cytokine factory responsible for Type II Diabetes (resistin), hypertension (angiotensinogen), autoimmune diseases and cancers, blood vessel inflammation (TNF, interleukin 6, PAL-1), and hunger (neuropeptide Y).  And mesenteric fat causes sleep apnea and gastric reflux simply as a result of its bulk.

For decades, surgeons have intervened to remove tumors of the mesentery or to untwist it in cases of volvulus to save compromised bowel.  However, Endcopic Visceral Lipectomy may well be the first intervention explicitly directed at the mesentery’s function as an organ to crease a diseased state, namely metabolic syndrome and Type II Diabetes.  Bravo.

 

 

BioSculpture Technology, Inc. establishes Obesity Control Research & Development Division

Robert Cucin MD JD MBA bariatric surgery, Diabetes, obesity, technology , , , ,

October 21, 2013 – BioSculpture Technology establishes the Obesity Control Research and Development Division.  The Division will consolidate and expand current efforts to develop improved methods and devices for the treatment of obesity, metabolic syndrome, and type 2 Diabetes mellitus.

2/3 of affluent populations are overweight and 1/3 are frankly obese.  43% of Developed World is forecast to be      obese in 10 years.  Obesity related chronic diseases account for 75% of overall healthcare spending.  Those diseases include type 2 Diabetes mellitus, hypertension, heart disease, gastric reflux, sleep apnea, autoimmune diseases and cancer.   Those diseases don’t just shorten lives, they reduce the quality of life.

80% of Type II Diabetics are obese. 1 out of 5 healthcare dollars is spent on Diabetes mellitus. Diabetes is the most frequent cause of kidney failure requiring dialysis and a frequent cause of blindness.

Already embarked on the goal of developing alternative bariatric treatments of obesity, metabolic syndrome and type II Diabetes mellitus, BioSculpture Technology has had three U.S. Patents allowed and has numerous U.S. and foreign Applications pending in this area.