glp 1 non diabetic A Balancing Act: GLP-1 Receptor Agonists for Non-Diabetic Obesity – Clinical Correlations The GLP-1 Agonists and Obesity:

In the world of incretin therapy, there are two important updates for your clinical practice

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The patient must: Be age 18 or older Have eligible Medicare Part D coverage Be prescribed treatment specifically for weight reduction and maintenance Participate in ongoing nutrition and physical activity intervention Not have already received a GLP-1 through their Part D plan Not be seeking coverage for another Part D-coverable indication, such as type 2 diabetes, moderate-to-severe obstructive sleep apnea, MASH, or cardiovascular risk reduction The patient must also have met one of these criteria when GLP-1 therapy was originally started: BMI 35 BMI 30 plus HFpEF, uncontrolled hypertension despite 2 medications, or CKD stage 3a+ BMI 27 plus prediabetes, prior MI, prior stroke, or symptomatic peripheral artery disease Important: Eligibility is based on BMI at treatment initiation, not necessarily the patients current BMI

The wild card-to-uncertainty about GLP-1 meds growth will be reimbursement: spending will continue to accelerate with upside if more widely reimbursed, IQVIA projects

However, DPP-4 inhibitors have not reduced the risk of major adverse cardiovascular events, possibly because potentiation of SDF-1 enhances plaque growth and instability, activates deleterious neurohormonal mechanisms, and promotes cardiac inflammation and fibrosis