Tirzepatide in Singapore
Key Takeaways:
Tirzepatide possesses a distinct mechanism, mimicking the actions of two important hormones: GLP-1 and GIP.
While many existing medications activate the GLP-1 receptor, Tirzepatide is different as it activates both GLP-1 and GIP receptors.
It is crucial to understand that Tirzepatide is a regulated prescription medication. Incorrect use can lead to significant side effects.
Consultation with a qualified medical specialist is essential to determine if this medication is a suitable option for your individual circumstances.
For sustained weight management and overall health, a holistic approach that incorporates lifestyle and dietary changes alongside any medical treatment is necessary.
Certain glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained attention for their ability to influence blood sugar levels and support weight loss. GLP-1 RAs can contribute to effective blood sugar management in individuals with diabetes and may also lead to weight reduction. Tirzepatide is a newer agent that works on these pathways.
Read more about GLP-1 RAs such as liragultide and semaglutide.
Are Tirzapetide and Semaglutide medications the same?
While both Tirzepatide and Semaglutide are designed to reduce appetite and affect related bodily processes, their mechanisms of action have some differences. Semaglutide medications primarily activate the GLP-1 receptor. Tirzepatide, however, activates both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors. This dual action is a key distinction.
Recent comparative research offers further insights, particularly for individuals with obesity who do not have type 2 diabetes. A 72-week, phase 3b clinical trial (known as SURMOUNT-5) directly compared the maximum tolerated doses of tirzepatide (10 mg or 15 mg once weekly) with semaglutide (1.7 mg or 2.4 mg once weekly) in this specific adult population.
Key findings from this study indicated:
Weight Reduction: Participants receiving tirzepatide experienced an average weight reduction of -20.2% from baseline at 72 weeks, compared to -13.7% for those receiving semaglutide. This difference was statistically significant (P<0.001).
Waist Circumference: Tirzepatide also led to a greater reduction in waist circumference, with an average decrease of -18.4 cm, compared to -13.0 cm with semaglutide (P<0.001).
Higher Weight Loss Thresholds: A higher percentage of participants in the tirzepatide group achieved weight reductions of at least 10%, 15%, 20%, and 25% compared to the semaglutide group.
Safety Profile: The most common adverse events reported in both groups were gastrointestinal (such as nausea, diarrhea, and vomiting), and these were mostly mild to moderate in severity, occurring primarily during the dose escalation phase.
The published study concluded that among participants with obesity but without diabetes, tirzepatide was superior to semaglutide in reducing body weight and waist circumference at 72 weeks.
It is important to understand that these are findings from a specific clinical trial, and individual responses to medication can vary. Your doctor is the best person to evaluate your specific health needs, discuss the full range of potential benefits and risks of any medication, and determine the most appropriate treatment options for you. Some GLP-1 RAs are approved for weight loss, while others are indicated primarily for managing type 2 diabetes, and suitability depends on a comprehensive medical assessment.
Potential Benefits Associated with Tirzepatide
Blood sugar control
Diabetes is characterized by elevated blood sugar levels. Maintaining blood sugar control is vital for reducing the risk of long-term diabetes-related complications, such as vision loss, kidney disease, and nerve damage. A diagnosis of diabetes is typically made when a person has a fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher, or a hemoglobin A1c (HbA1c) level of 6.5% or higher.
GLP-1 RAs and dual GIP/GLP-1 RAs like Tirzepatide have been shown in clinical studies to effectively contribute to blood sugar control, making them viable considerations for many diabetes patients under medical supervision.
Weight Management
These medications have also demonstrated potential in aiding weight loss, which can, in turn, help reduce the risk of complications associated with diabetes and excess weight. Furthermore, direct comparative studies, such as the SURMOUNT-5 trial focusing on adults with obesity but without diabetes, have provided data on the extent of weight loss that may be achievable with Tirzepatide compared to other medications like semaglutide, underscoring the importance of discussing specific trial outcomes with your doctor.
To be considered a candidate for receiving a GLP-1 RA or a dual GIP/GLP-1 RA for weight loss, an individual typically needs to have a body mass index (BMI) that indicates obesity. This means their body weight is at a level that poses a significant risk of health complications. Alternatively, they might have a slightly lower body weight but are already experiencing weight-related health issues (such as type 2 diabetes, high blood pressure, or high cholesterol).
Based on available scientific research, the World Health Organization recommends slightly different BMI targets for Asian and non-Asian populations. To be a candidate for receiving such a medication for weight loss, a person generally needs to meet one of the following criteria, as assessed by a medical professional:
For non-Asians: A BMI of 30 or greater, or a BMI of 27 or greater along with health complications of being overweight.
For Asians: A BMI of 27.5 or greater, or a BMI of 23 or greater along with health complications of being overweight.
Understanding How Tirzepatide Works
Tirzepatide is a synthetic peptide. Its unique ability lies in mimicking the action of two different types of natural hormones in the body: GLP-1 and GIP.
GLP-1 RAs mimic a natural hormone called glucagon-like peptide 1 (GLP-1). GLP-1 helps regulate digestion and appetite. The actions associated with GLP-1 include:
Slowing down the emptying of the stomach after a meal, which can contribute to a prolonged feeling of fullness.
Potentially reducing cravings and influencing eating patterns.
Helping the pancreas release insulin when blood sugar levels are high. Insulin allows the body to use glucose from food for energy by moving it from the blood into cells.
Preventing the liver from releasing excessive sugar into the blood.
Meanwhile, GIP hormones are understood to:
Stimulate insulin secretion.
Improve insulin sensitivity.
Aid GLP-1 hormones in their digestive and metabolic actions, for example, by potentially enhancing their effects on appetite regulation.
Therefore, Tirzepatide represents a newer class of medication. Instead of being a single-receptor agonist like semaglutide, Tirzepatide activates two distinct receptors simultaneously – GLP-1 and GIP.
An international research collaboration sought to examine how Tirzepatide produces its effects on blood sugar and weight. The findings suggested that Tirzepatide triggers a strong GIP receptor response in addition to activating GLP-1 receptors. This dual-receptor action means Tirzepatide engages two distinct pathways involved in blood sugar control and weight regulation. Research suggests this combined approach may lead to more significant effects compared to agents that target GLP-1 receptors alone.
Clinical trials evaluating Tirzepatide for the treatment of type 2 diabetes have demonstrated improvements in HbA1c and fasting plasma glucose levels in patients when used alone or in addition to other diabetes medications like metformin, SGLT2 inhibitors, and/or basal insulin.
Furthermore, a 72-week clinical trial involving adults with obesity and with at least one weight-related complication, excluding diabetes, found that participants taking Tirzepatide (5mg, 10 mg, or 15 mg) achieved average weight loss of up to 20.9%. It's important to remember that individual results can vary.
For sustainable weight loss and health improvements, a holistic approach that includes lifestyle and dietary changes remains paramount.
How is Tirzepatide Administered?
Tirzepatide is self-administered once weekly via subcutaneous injection (under the skin) in the abdomen, thigh, or upper arm. The specific dosage required depends on the individual and must be determined by a doctor, who will also provide dosing instructions.
What are the More Common Side Effects of Tirzepatide?
Tirzepatide can cause certain side effects. The most common side effects reported in clinical trials, particularly during the dose-escalation period, include:
Nausea and diarrhea
Decreased appetite
Vomiting
Constipation
Indigestion
Stomach Pain
Tirzapetide may also cause serious side effects. Reported side effects include:
Severe digestive problems, which may lead to acute kidney injury
Gallbladder problems
Pancreatitis
Risk of thyroid C-cell tumors (seen in animal studies; relevance to humans is being evaluated)
Severe allergic reaction
It is essential to discuss all potential side effects with your doctor.
Is Tirzepatide Right for You?
Tirzepatide and similar medications are not available over the counter and can only be obtained by prescription. Therefore, a consultation with a doctor is necessary to explore this option. Not all clinics in Singapore may carry Tirzepatide, so if you are considering this medication, it is advisable to check with the clinic before scheduling an appointment.
Deciding if a prescription medication like Tirzepatide is appropriate is a significant decision that must be made in close consultation with a specialist.
Medication, if prescribed, is generally most effective when part of a comprehensive plan. Tirzepatide, whether for weight loss or diabetes management, should be integrated with sustainable, healthy lifestyle habits that support long-term well-being.