b'Weight Loss Similar in Older/Younger Veterans on Semaglutide Concerns have been raised about GLP-1 receptor agonists possibly causing unintended weight loss in older adults. A new VA study has put that worry to rest, finding no significant difference in weight loss with semaglutide use among veterans 65 or older compared to those who are younger. The authors concluded that age does not appear to be a robust predictor of semaglutides effect on weight.By Annette M. BoyleDALLASDiabetesguidelinesrecommendit.metabolic syndrome, obstructive sleep apnea, osteo-Doctors prescribe it. Weight loss centers bemoan it.arthritis or nonalcoholic fatty liver disease. They also Celebrities (mis)use it and pharmacists cant keepmust have failed to lose at least 5% of body weight or it in stock. Semaglutide has upended diabetes treat- be contraindicated for two other weight management ment and weight management like no other drug. medications or have other issues requiring additional Semaglutide is a glucagonlike peptide-1 (GLP-1)support to lose weight.receptoragonist(RA)thatreducesbloodglucose levelsbystimulatinginsulinsecretionwhilesup- Unintended Weight Losspressing glucagon secretion. It also increase uptakeAsveteransswitchedfromanotherGLP-1RAto of glucose, boosts glycogen synthesis in peripheralsemaglutide in response to its preferred status, cli-tissues, promotes satiety and slows gastric emptying.nicians at the VA North Texas Health Care System The combination of effects has made it a powerful(VANTHCS) in Dallas sought to better understand tool in management of Type 2 diabetes and weightthe impact of the drug on elderly veterans, particu-loss.Semaglutideisavailableasasubcutaneouslarly in terms of unintended weight loss. In younger weekly injection or as a daily pill. patients, losing weight while achieving better con-Whilesocialmediainfluencersmightbethebesttrol of blood glucose is typically seen as a bonus. For known users, veterans could be the poster image forelderly patients, it might not be as beneficial, given the drug. A quarter of veterans have diabetes; 40% arethe association between weight loss and increased classified as obese; and, given the relationship betweenmorbidity and mortality in this population.obesity and diabetes, a significant percentage are both. ResearchersatVANTHCSundertookastudyto TheVAhasrespondedbycoveringsemaglu- determine whether elderly veterans with T2D experi-tideasthepreferredGLP-1RAforType2dia- enced greater weight loss than younger veterans and, betes.AccordingtotheVAPharmacyBenefitsconsequently,whetherinterventionsarerequired. ManagementServices,semaglutidecanbepre- If the difference is significant, greater attention is scribed to veterans with Type 2 diabetes (T2DM)needed in the elderly initiating semaglutide to pre-who have inadequate glycemic control despite tak- vent adverse outcomes, the researchers noted. 1ing metformin and/or sulfonylurea and have a base- The team evaluated records for 1,045 veterans line HbA1c of at least 7.5%. treated for Type 2 diabetes at the Dallas VAMC Semaglutidealsocanbeprescribedtoveteranswhowereprescribedsemaglutideforthefirst for chronic weight management if they have a bodytimebetweenOct.1,2020,andOct.25,2021, mass index (BMI) above 30 kg/m2 or above 27 kg/ and stayed on it for at least 3 months. Of those, m2 and at least one weight-related comorbidity suchonly 177 had documented weights taken within 90 ashypertension,Type2diabetes,dyslipidemia,days prior to starting semaglutide and follow-up Continued on Page 98 u91'