Team Metabolic Health
Given their effects on various organs, they could potentially help you remain functional
“New diabetes drugs may delay ageing” made headlines across the media. The reference was to a study using glucagon-like peptide receptor agonist (GLP1RA), which mimics the hormone incretin to regulate appetite and blood glucose levels. Semaglutide, popularly known as Ozempic, belongs to this class of drugs and is known for controlling blood sugar, suppressing hunger and reducing weight. Are they truly anti-ageing, too?
What is ageing?
Ageing is a highly complex biological process. Our DNA is constantly being broken down and repaired. An imbalance in this process, leading to poor repair of DNA, is one of the hallmarks of ageing. Telomere shortening, deranged protein metabolism and altered sensing of nutrients are other features. These changes lead to cellular senescence (cells lose their power to grow and multiply), reduced tissue regeneration and reduced communication between cells.
Some of the “anti-ageing” benefits seen with GLP1RAs may simply be the result of their weight-loss inducing properties. (File image)
What’s the link between weight loss drugs and ageing?
GLP1RAs have been shown to protect against oxidative stress, cellular senescence and chronic inflammation, which are widely accepted as the major risk factors of ageing. This is characterised by memory loss, cognitive impairment and coordination deficits. Recent studies suggest that GLP1RAs could have beneficial neuroprotective effects. A large study from Sweden showed that in people with Type 2 diabetes, the use of GLP-1RA was associated with 23-30 per cent lower risk of dementia, compared with other anti-diabetic agents.
There are several common pathological processes in Alzheimer’s Disease, a brain disorder that causes a gradual decline in memory and thinking skills, and Type 2 diabetes. These include impaired glucose metabolism, insulin resistance, increased oxidative stress and increased inflammation. Alzheimer’s Disease has been referred to as diabetes of the brain.
What’s their efficacy in managing diseases?
GLP1RAs have shown great promise in treating Alzheimer’s and have also shown some efficacy in treating Parkinson’s disease. Definitive, larger studies are ongoing on this subject. Some of the “anti-ageing” benefits seen with GLP1RAs may simply be the result of their weight-loss inducing properties. Obesity promotes the development of Type 2 diabetes, heart disease and early death. Reduction in body weight can prevent, delay or reduce the development of these conditions with advancing age.
GLP-1RAs, including semaglutide, have been shown to reduce the risk of cardiac complications in people with Type 2 diabetes. The SELECT trial tracked more than 17,600 people, aged 45 or older, as they were given either 2.4 mg of semaglutide or a placebo for more than three years. Participants were obese or overweight and had cardiovascular disease but were not diabetic. Men and women who took the drug died at a lower rate from all causes, including cardiovascular issues and Covid-19. People using the weight-loss drug were less likely to die from Covid (2.6 per cent vs 3.1 per cent). Heart failure, too, was lower in the semaglutide group.
Results of the FLOW trial published earlier this year showed that semaglutide slowed the progression of kidney disease in people with diabetes by 24 per cent. Studies have further shown a reduction in fatty liver disease with GLP-1RAs. Reduction in liver fat could reduce chances of chronic liver disease and its serious, at times fatal consequences.
One concern with the use of GLP1RAs is the muscle loss that accompanies profound weight loss — such muscle loss can potentially lead to frailty, falls and fractures, and prove to be a negative impact of this class of drugs in the elderly.
Credit: The Indian Express