Speaker : Rashid Khairi
The speaker will discuss Semiglutide (Ozempic for diabetes, Wegovey for obesity) and Terzaoatude (Mounjaro for diabetes, Zepbound for obesity). The talk will include the mechanism of action, the drugs effects on diabetes and obesity, and side effects. He will also talk about discontinuation and adherence rates for this treatment. There are additional benefits that have been gained from these drugs. There are newer drugs for these conditions on the horizon.
Rashid A. Khairi was born in Ghazipur, India. He has a BS from Punjab University and an MBBS(MD) from Karachi University. He is a member of the Royal College of Physicians in London, Diplomat American Board of Internal Medicine, Diplomat American Board of Internal Medicine (Endocrinology).
He was a staff physician at St. Vincent Hospital and Community Hospitals Indianapolis. He was president of Physicians Research Group and Indiana Center for Health and Nutrition. He was a Principal Investigator in Phase 2,3, and 4 clinical trials for many pharmaceutical drugs now on the market.
He is a founding member of the Pakistan American Friendship Association and has served as its President.
Program: Wonder Drugs for Diabetes and Obesity
Speaker: Rashid Khairi, MD, Endocrinology and Internal Medicine, Community Health Network
Introduced By: Rick Whitener
Attendance: NESC: 100; Zoom: 38
Guest(s): Dennis Mathews, JoAnn Schisla, Jim Souers and one or two more unlogged.
Scribe: Alan Schmidt
Editor: Carl Warner
Talk’s Zoom recording found at: https://www.scientechclubvideos.org/zoom/07142025.mp4
Today’s speaker, Rashid Khairi, holds a BS degree from Punjab University and an MBBS (MD) from Karachi University. He is a member of the Royal College of Physicians in London, Diplomat of the American Board of Internal Medicine, and Diplomat of the American Board of Internal Medicine (Endocrinology). He was a staff physician at St. Vincent Hospital and Community Hospital and president of Physicians Research Group and the Indiana Center for Health and Nutrition. Dr. Khairi was a principal investigator for clinical trials for numerous pharmaceutical drugs now on the market. He is a founding member of the Pakistan American Friendship Association and has served as its president.
Dr. Khairi discussed semaglutide (Ozempic for diabetes, Wegovey for obesity) and tirzepatide (Mounjaro for diabetes, Zepbound for obesity). The talk covered the mechanisms of action, the drugs’ effects on diabetes and obesity, as well as its side effects. He also talked about discontinuation and adherence rates for this treatment. There are additional benefits that have been gained from these drugs. Newer drugs for these conditions are on the horizon.
There are twin epidemics of obesity and diabetes. For 60 year old men in 1890, one in thirty adults were obese; in 2000, one in three adults are obese. From 1890 to 1940, one in 50,000 adults was diabetic, while in 2000 one in nine adults are diabetic. Obesity and diabetes are two of the most common diseases in the United States and the world. A hypothesis is that overnutrition and lack of exercise increases fat stores. Obesity is the leading risk factor for diabetes, cardiovascular disease, neurocognitive impairment, cancer, and arthritis. While lifestyle modification, such as diet and exercise, remains the cornerstone of obesity management, many people are not successful in losing weight because of pathology in hunger control.
GIP and GLP-1 act on hunger with actions in peripheral tissues of the human body including insulin secretion and sensitivity. The diabetes medications decreased the hemoglobin A1c 1 to 2.5% with 70% of the patients reaching the goal of hemoglobin A1c less than 7%. The medications can prevent type 2 diabetes in patients with prediabetes. Weight loss of 12 – 15% was seen after treatment with Ozempic and is maintained when patients are treated for up to 4 years. Tirzepatide trials have shown weight loss of 20% or more. Rebound weight gain is seen after discontinuation of treatment for both drugs. Most common side effects are nausea, vomiting, diarrhea, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, GERD, flatulence, gastroenteritis, and hypoglycemia in type 2 diabetics. 50% of the people discontinue the medications due to cost and side effects.
Broader impacts and benefits of these drugs include improving cardiovascular health, reducing sleep apnea, dementia prevention, treating addiction in addictive behaviors, potential for improvement of liver and kidney diseases, enhancing immune function, and helping osteoarthritis. The key question is whether these benefits are related to weight loss, or they are the direct effect of metabolic improvement.
Recommended foods: lean proteins such as chicken, turkey, fish, tofu, and legumes (aim for 1.2 to 1.5 gm protein per kilogram body weight daily); high-fiber foods: vegetables, fruits, whole grains, legumes; healthy fats: avocado, nuts seeds, olive oil, fatty fish; hydrating options: water-rich fruits, vegetables, and soups (target is 64 to 80 ounces of water per day).
Foods to avoid or limit: high fat and fried food can worsen nausea, bloating and indigestion; sugary foods and drink such as soda, candy, and pastries; highly processed foods such as packaged snacks, frozen meals, and fast foods. Alcohol and carbonated beverages may intensify G.I. side effects.
Rashid Khairi
