Tag: #type 2 diabetes

The Importance of Glucose Control for Weight Loss and Overall Health

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Maintaining stable blood glucose levels is one of the most critical factors in achieving not only weight loss but overall optimal health. Blood sugar fluctuations affect your energy levels, hunger cues, mood, and hormones, all of which influence your body’s ability to lose or maintain weight. Let’s dive into the science behind glucose control, its broader impacts on your health, and practical ways to maintain it.

The Impact of Erratic Glucose Spikes on the Body

When you consume foods high in simple carbohydrates or sugar, your blood glucose spikes. This triggers a cascade of hormonal reactions, primarily involving insulin—a hormone produced by the pancreas to help transport glucose into cells. However, erratic glucose spikes can overwhelm the system, leading to several negative effects on the body, especially on the Hypothalamic-Pituitary-Adrenal (HPA) Axis.

HPA Axis Dysregulation and Hormonal Imbalance: The HPA axis is a critical regulator of stress response and hormone production, including cortisol. Studies have shown that frequent glucose spikes and crashes can dysregulate the HPA axis, leading to elevated cortisol levels. This chronic cortisol elevation can contribute to hormonal imbalances such as:

  • Increased fat storage, especially around the abdomen.
  • Sleep disturbances, as high glucose can interfere with the body’s ability to produce melatonin, the hormone responsible for sleep regulation.
  • Gut health issues, as glucose dysregulation can lead to inflammation, impairing gut barrier function and affecting the microbiome.
  • Sexual dysfunction, since the endocrine system (responsible for hormone balance) is closely tied to sexual health, including libido and reproductive function.

Long-Term Risks of Uncontrolled Glucose Levels

Over time, poor glucose control can lead to insulin resistance, a condition where your cells no longer respond effectively to insulin, causing blood glucose levels to remain elevated. Insulin resistance has a strong connection to a variety of health issues, including:

  1. Weight Gain: Persistent insulin resistance often leads to weight gain, particularly around the abdomen.
  2. Hormonal Imbalance: Insulin resistance disrupts other hormonal systems, including thyroid and reproductive hormones.
  3. Gut Diseases: High blood sugar levels can foster an environment that promotes gut dysbiosis, which is linked to conditions like Irritable Bowel Syndrome (IBS) and leaky gut.
  4. Mental Health Problems: Studies have shown a clear connection between erratic glucose levels and mood disorders like anxiety and depression. Glucose spikes lead to inflammation, which has been shown to contribute to these mental health challenges.

Evidence-Based Tips for Balancing Glucose Levels

So how to do you achieve more consistent glucose levels? Every person may be a little different as our bodies are not the same, but some of the tips my patients have found to be helpful include:

  1. Eat Balanced Meals: Incorporating protein, healthy fats, and fiber with each meal helps slow down glucose absorption, keeping blood sugar levels stable. This has been supported by research from the American Diabetes Association, which emphasizes the importance of balanced macronutrient intake to prevent spikes.
  2. Choose Low-Glycemic Foods: Opt for whole grains, legumes, vegetables, and other low-glycemic foods, which release glucose more slowly into the bloodstream. According to the Glycemic Index Foundation, low-GI foods can help reduce insulin resistance and support weight loss.
  3. Exercise Regularly: Physical activity increases your cells’ sensitivity to insulin, allowing them to more effectively use glucose. The World Health Organization (WHO) recommends at least 150 minutes of moderate aerobic activity per week for glucose regulation.
  4. Stay Hydrated: Dehydration can raise blood sugar levels. Drink plenty of water throughout the day to support healthy glucose levels. This half of your bodyweight in ounces!
  5. Manage Stress: Chronic stress contributes to HPA axis dysregulation, elevating cortisol and impacting glucose regulation. Meditation, yoga, and deep breathing exercises are all excellent ways to lower stress. I love using the Peloton for this as they have a variety of options to choose from!

Signs and Symptoms of Glucose Dysregulation

So how do you know if you are experiencing high or low glucose levels? Again, this can be different for everyone, but research has shown that there are some common symptoms that people may experience on both spectrums:

High Blood Sugar (Hyperglycemia) Symptoms:

  • Fatigue
  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Unexplained weight loss
  • Difficulty concentrating

Low Blood Sugar (Hypoglycemia) Symptoms:

  • Shakiness
  • Sweating
  • Dizziness
  • Hunger
  • Irritability
  • Palpitations
  • Weakness

If you notice these symptoms, it’s essential to seek medical attention and monitor your glucose levels. This is where I like to use a continuous glucose monitor if possible!

Lab Tests to Assess Glucose Control

Let’s talk labs for a second. There a several blood tests that can provide valuable insight into your glucose metabolism, but here are my favorite to trend with my patients:

  1. Fasting Blood Glucose: This test measures your blood sugar levels after an overnight fast. A normal level is below 100 mg/dL, while 100-125 mg/dL indicates prediabetes, and 126 mg/dL or higher signals diabetes.
  2. Insulin Levels: Measuring fasting insulin levels can help detect insulin resistance, even if blood sugar levels appear normal. An ideal fasting insulin level is typically below 15 µU/mL.
  3. Hemoglobin A1C (HgA1c): This test measures your average blood sugar levels over the past 2-3 months. A normal A1c is below 5.7%, prediabetes is 5.7%-6.4%, and diabetes is 6.5% or higher.

*Remember that for fasting levels, these need to be drawn between the hours of 7-9am and on an empty stomach.

Continuous Glucose Monitors (CGMs): A Valuable Tool for Glucose Control

I have talked a little bit about CGMs before, but let’s do a repeat! For individuals seeking to closely monitor glucose fluctuations, a Continuous Glucose Monitor (CGM) can be an incredibly useful tool. These devices measure glucose levels in real-time and provide a continuous record of how food, exercise, and stress impact your blood sugar (a Dexcom would be an example). Although these are wonderful to use, let’s break down the pros and cons:

Pros of Using a CGM:

  • Provides real-time feedback on your diet and lifestyle choices.
  • Can identify blood sugar spikes that may not be caught by standard lab work.
  • Helps you understand how stress, exercise, and sleep impact your glucose levels.

Cons of Using a CGM:

  • They can be expensive and may not be covered by all insurance plans.
  • CGMs require frequent calibration and monitoring.
  • Some people may experience skin irritation from the device adhesive.

If you are interested in using a CGM I would highly encourage you to speak to your healthcare provider. I do use these periodically in my current practice, however, this is done on an individual basis.

Wrapping it up!

Maintaining stable glucose levels is crucial for weight management, hormone balance, gut health, and overall wellness. Regular monitoring through lab tests like fasting glucose, insulin levels, and HgA1c, combined with tools like CGMs, can offer valuable insights into your body’s glucose regulation. By making small, evidence-based changes in your diet and lifestyle, you can protect yourself from the long-term health risks associated with uncontrolled glucose levels and achieve better overall health.

Take control of your glucose, and in turn, take control of your health!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

REFERENCES

American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S1-S2. https://doi.org/10.2337/dc22-SINT

Cryer, P. E. (2016). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 39(4), 556-562. https://doi.org/10.2337/dc15-2715

Glycemic Index Foundation. (n.d.). The glycemic index. Glycemic Index Foundation. https://www.gisymbol.com/about-glycemic-index/

International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation. https://diabetesatlas.org/

Mayo Clinic Staff. (2021). Insulin resistance: What it is and how to know if you have it. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/insulin-resistance/art-20047903

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Hypoglycemia. National Institutes of Health. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/hypoglycemia-low-blood-glucose

Reaven, G. M. (2005). The insulin resistance syndrome: Definition and dietary approaches to treatment. Annual Review of Nutrition, 25, 391-406. https://doi.org/10.1146/annurev.nutr.25.050304.092514

World Health Organization. (2020). Physical activity guidelines for health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/physical-activity

How Stress Can Affect Blood Glucose Levels, Insulin Secretion, and Cause Weight Gain

by Roxy Functional Wellness, posted in Health & Wellness, stress management, Weight Loss

Understanding the Impact of Stress on Blood Glucose and Insulin

Stress is an inevitable part of life, but its effects extend beyond mental strain. When we experience stress, our body responds by releasing stress hormones such as cortisol and adrenaline. These hormones are part of the body’s “fight or flight” response, which historically helped humans survive dangerous situations. However, in our modern world, chronic stress can wreak havoc on our health, particularly on our blood glucose levels and insulin secretion.

How does Stress affect Glucose, and Insulin?

During periods of stress, cortisol and adrenaline cause the liver to release more glucose into the bloodstream to provide immediate energy. At the same time, these hormones can inhibit or insulin secretion or reduce insulin sensitivity, leading to higher blood glucose levels. This mechanism is beneficial in acute stress situations but can be detrimental when stress becomes chronic.

When blood glucose levels are consistently high, the pancreas needs to produce more insulin to help cells absorb the glucose. Over time, this can lead to insulin resistance, where the body’s cells no longer respond effectively to insulin. This condition can cause higher levels of glucose in the blood and eventually lead to Type II Diabetes, weight gain, and other inflammatory conditions.

Photo by Karolina Kaboompics on Pexels.com

How Stress-Induced Changes Can Lead to Weight Gain

Even when following a healthy lifestyle with balanced nutrition and regular exercise, chronic stress can undermine weight management efforts. If our body is in a chronic state or stress and/or agitation, it isn’t going to feel “safe”. Elevated cortisol levels can contribute to weight gain in several ways:

  1. Increased Appetite: Cortisol can stimulate appetite, leading to increased food intake, especially of high-calorie, sugary, and fatty foods. When you find yourself running through that Dunkin Donut drive-thru for that late afternoon donut after a stressful day, this would be why! Our body uses a lot of fuel during stressful times. Instead of doing inventory and using what we already have, it makes us feel like we need to eat more. Specifically high carb and sugary foods as this gives us the quickest energy.
  2. Fat Storage: High cortisol levels promote the storage of fat, particularly in the abdominal area, which is associated with a higher risk of metabolic diseases. I always think of that outside cat that is preparing for a stressful, cold winter by gaining that extra belly fat. They always put on some weight expecting to lose weight over the course of the winter. This makes sense for them, but not for us.
  3. Reduced Muscle Mass: Chronic stress can lead to muscle breakdown, decreasing overall metabolic rate and making it harder to maintain or lose weight. This can be detrimental for people as muscle mass is tied to longevity and overall wellness.

The Role of Continuous Glucose Monitors (CGMs)

When weight gain occurs despite healthy lifestyle choices, it may be useful to monitor blood glucose levels more closely. Continuous glucose monitors (CGMs) provide real-time data on glucose levels throughout the day and night, offering insights into how stress and other factors affect glucose metabolism. I have a whole new appreciation for CGMs after using one myself. It provided insight into our my body responds to stressful situations, a poor night of sleep, and my eating choices better than anything else I had tried previously! If using one, be prepared to be frustrated sometimes as things you thought were healthy your body may not respond to them in a healthy manner.

Normal Readings on a CGM

So what are normal CGM readings? A CGM provides continuous readings, typically every few minutes. Normal glucose levels for most people without diabetes are:

  • Fasting (before meals): 70-100 mg/dL (this can vary and many CGMs can be individualized)
  • Postprandial (1-2 hours after eating): less than 140 mg/dL
  • Overall, maintaining a time-in-range (TIR) of 70-140 mg/dL for at least 70% of the time is considered good control.

Your levels can be affected by stress and food, but can also be affected by other things like sauna use and exercise. I always like to remind patients this as they can sometimes see a spike into the 150s during exercise. This is normal as the body is trying to make sure your body has enough fuel to use.

Types of Continuous Glucose Monitors and Their Pros and Cons

  1. Freestyle Libre
    • Pros: No fingerstick calibration, 14-day sensor life, easy to use.
    • Cons: No alarms for high or low glucose levels, requires a separate reader or smartphone app.
  2. Dexcom G6
    • Pros: No fingerstick calibration, customizable alerts for high and low glucose levels, integrates with various insulin pumps.
    • Cons: Higher cost, 10-day sensor life, requires a transmitter that needs periodic replacement.
  3. Medtronic Guardian Connect
    • Pros: Predictive alerts for high and low glucose levels, integrates with Medtronic insulin pumps.
    • Cons: Requires fingerstick calibration, higher cost, 7-day sensor life.
  4. Dexcom G7 (this is my favorite and what I use!)
    • Pros: Improved accuracy, no fingerstick calibration, smaller and more discreet, fast warm-up time, customizable alerts, app integration, integration with other devices.
    • Cons: Can be expensive, sensor adhesion (some have allergies), learning curve (lots of information), battery life, data gaps due to transmission error.

How to Get a CGM

Obtaining a CGM usually involves the following steps:

  1. Consult Your Healthcare Provider: Discuss your need for a CGM and get a prescription.
  2. Check Insurance Coverage: Verify if your insurance covers CGMs and understand the cost implications.
  3. Purchase the Device: Buy the CGM from a pharmacy, medical supply company, or directly from the manufacturer.
  4. Training: Some CGM providers offer training sessions to help you learn how to use the device effectively.

I highly recommend working with your provider or reputable company (like Signos) that will walk you through the use and reading of your CGM. This will prevent you from getting frustrated and will ensure you get the most out of your CGM.

Photo by Nutrisense Inc on Pexels.com

Techniques and Natural Remedies to Reduce Stress

Now that we know the affect that stress can have on our glucose and insulin levels, managing stress is essential for maintaining balanced glucose levels and preventing weight gain. Here are some techniques and natural remedies that can help reduce stress:

  1. Yoga and Meditation: Regular practice can lower cortisol levels, improve insulin sensitivity, and promote relaxation.
  2. Physical Activity: Engaging in regular exercise reduces stress hormones and improves overall metabolic health.
  3. Mindfulness Practices: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness meditation can help reduce stress.
  4. Herbal Supplements: Adaptogenic herbs like ashwagandha, rhodiola, and holy basil can help manage stress and support adrenal health.
  5. Adequate Sleep: Prioritizing sleep and maintaining a consistent sleep schedule can reduce stress and improve metabolic function.
  6. Balanced Diet: Eating a diet rich in whole foods, healthy fats, and lean proteins can support stress management and overall health.

By understanding the connection between stress, blood glucose levels, and insulin secretion, and by utilizing tools like CGMs, individuals can take proactive steps to manage their health more effectively. Incorporating stress-reducing techniques and natural remedies can further support this journey towards better health and well-being.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Diabetes Association. (2021). Understanding insulin resistance. Retrieved from https://www.diabetes.org/diabetes/insulin-resistance

Cryer, P. E. (2018). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 34(Supplement 2), S165-S171. doi:10.2337/dc11-s218

Dedov, I., Maslova, O., & Suntsov, Y. (2020). Continuous glucose monitoring in diabetes management. Diabetes Therapy, 11(3), 509-526. doi:10.1007/s13300-020-00786-8

Fisher, M. (2016). The role of cortisol in stress and the effects on glucose metabolism. Endocrinology and Metabolism Clinics of North America, 45(1), 55-68. doi:10.1016/j.ecl.2015.09.005

Freestyle Libre. (2023). Freestyle Libre 14 day system. Retrieved from https://www.freestylelibre.us/

Dexcom. (2023). Dexcom G6 continuous glucose monitoring (CGM) system. Retrieved from https://www.dexcom.com/

Helgeson, V. S., Escobar, O., Siminerio, L., & Becker, D. (2017). Relation of stressful life events to metabolic control among adolescents with diabetes: 5-year longitudinal study. Health Psychology, 36(11), 1061-1071. doi:10.1037/hea0000491

Medtronic. (2023). Guardian Connect CGM system. Retrieved from https://www.medtronicdiabetes.com/products/guardian-connect-continuous-glucose-monitoring-system

National Center for Complementary and Integrative Health. (2020). Yoga: In depth. Retrieved from https://www.nccih.nih.gov/health/yoga-in-depth

Rawshani, A., Rawshani, A., Franzén, S., Eliasson, B., Svensson, A. M., Miftaraj, M., & Gudbjörnsdottir, S. (2018). Mortality and cardiovascular disease in Type 1 and Type 2 diabetes. New England Journal of Medicine, 376(15), 1407-1418. doi:10.1056/NEJMoa1608664

Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2018). The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International Journal of Cardiology, 141(2), 122-131. doi:10.1016/j.ijcard.2010.09.047

Van der Kallen, C. J., van Greevenbroek, M. M., Ferreira, I., & Stehouwer, C. D. (2017). The association of central fat mass with all-cause mortality and cardiovascular disease is dependent on inflammatory properties of adipose tissue: The Hoorn study. Diabetes Care, 30(11), 3035-3040. doi:10.2337/dc07-1075

Understanding GLP-1 Medications: How They Work and Their Role in Weight Loss

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

In recent years, GLP-1 medications such as Ozempic, Wegovy, and Mounjaro have garnered significant attention for their role in aiding weight loss and managing Type 2 Diabetes; most recently, research has even shown their benefit in those with heart disease. While these medications offer promising benefits, it is crucial to understand their limitations and the importance of a comprehensive approach to health and wellness.

Photo by SHVETS production on Pexels.com

The Physiology and benefit of GLP-1 Medications

GLP-1 stands for glucagon-like peptide-1, a hormone produced in the gut that plays a significant role in regulating appetite (as well as cravings!) and blood glucose levels. Specifically, GLP-1 medications interact with the gut microbiome and influence the following:

  1. Appetite Regulation: GLP-1 medications mimic the action of the natural GLP-1 hormone. When these medications are introduced into the body, they bind to GLP-1 receptors in the brain, particularly in areas that control hunger and satiety. This interaction helps reduce appetite and increase feelings of fullness, leading to reduced food intake. This effect is a favorite of many as it forces one to eat less and not have as much “food noise” when deciding food options.
  2. Slowing Gastric Emptying: These medications slow down the rate at which the stomach empties food into the small intestine. This delayed gastric emptying helps prolong the feeling of fullness after eating, further aiding in appetite control and reducing overall calorie intake.
  3. Insulin Secretion: GLP-1 stimulates the pancreas to release insulin in response to food intake, helping to lower blood sugar levels. It also suppresses the release of glucagon, a hormone that increases blood sugar levels. This dual action helps maintain better glucose control, which is particularly beneficial for individuals with Type 2 Diabetes. This also reduces cravings due to the lack of up and down spikes in glucose.
  4. Reduction of Glucose Production: By inhibiting glucagon release, GLP-1 medications also reduce the liver’s production of glucose, contributing to lower blood sugar levels.

Many users of GLP-1 medications find that they experience significant weight loss, sometimes as much as 20% of their weight due to how they work in our bodies. Besides the weight loss, many find the decrease in “food noise” or the constant thinking of what to eat next to be comforting and helpful in making better, more healthy food choices.

Photo by Pavel Danilyuk on Pexels.com

Short-Term vs. Long-Term Use for Weight Loss

When considering GLP-1 medications for weight loss, it’s important to understand their role in both short-term and long-term use:

Short-Term Use

In the short term, GLP-1 medications can kickstart weight loss efforts by providing immediate benefits in appetite control and blood sugar regulation. This initial phase can be particularly motivating for individuals looking to make significant lifestyle changes. Additionally, I have also had success using GLP-1 medications in those that have reached a plateau in their weight loss and/or that have a small amount of weight to lose. However, the short-term use of these medications is generally not recommended as a standalone solution. Without ongoing support and lifestyle adjustments, the weight loss achieved may not be sustainable.

Long-Term Use

For sustained weight loss and health benefits, GLP-1 medications are often used as part of a long-term treatment plan. Long-term use helps maintain the physiological benefits of appetite regulation and blood sugar control, which can be crucial for individuals with chronic conditions like obesity and Type 2 Diabetes. It is important to note that long-term use of GLP-1 medications should always be supervised by a healthcare provider to monitor effectiveness, manage side effects, and adjust dosages as needed.

“Despite their benefits, GLP-1 medications are not a cure-all solution.”

The Importance of Professional Guidance

Despite their benefits, GLP-1 medications are not a cure-all solution. Working with a healthcare provider experienced with these medications is essential. I cannot stress this enough as there are many companies popping up across the nation that profess being an expert in obesity management and that are prescribing GLP-1 medications with little follow-up. Here’s why:

  1. Personalized Care: An experienced healthcare provider can tailor treatment to your specific needs, ensuring that the medication is used safely and effectively. When working with a provider, ask what framework they utilize to develop a plan for their patients. The Obesity Medicine Association (OMA) has developed the gold standard on obesity management and set the standard for providers offering obesity management services.
  2. Monitoring Side Effects: Common side effects include nausea, vomiting, and digestive issues. Those with a history of medullary thyroid cancer and/or frequent pancreatitis are not candidates for GLP-1 medications. A healthcare provider can help manage these side effects and adjust the treatment plan as needed.
  3. Comprehensive Approach: A healthcare provider can integrate GLP-1 medication into a broader wellness plan that includes diet, exercise, and mental health support. GLP-1 medications are NOT miracle drugs and should not be treated as such.

Maintaining Lean Muscle Mass

One of the concerns with rapid weight loss is the potential loss of lean muscle mass. Loss of muscle mass is not something to take lightly, which is why I wanted to specifically separately it out in this post. Maintaining muscle mass is crucial for overall health, metabolism, and functional strength. Recent studies have shown that muscle mass is linked to longevity, meaning that the more muscle mass a person has, the more likely they are to live longer and happier. Here are some strategies to ensure you preserve muscle while using GLP-1 medications:

  1. Protein Intake: Ensure you consume enough protein to support muscle repair and growth (approximately 0.8-1g/kg/day). Include high-quality protein sources such as lean meats, fish, eggs, dairy, legumes, and plant-based proteins in your diet.
  2. Resistance Exercise: Incorporate strength training exercises into your routine at least 2-3 times a week. Resistance exercises like weight lifting, bodyweight exercises, Pilates, and resistance band workouts help build and maintain muscle mass.
  3. Balanced Nutrition: In addition to protein, ensure your diet includes a variety of nutrients to support overall health. A balanced diet will provide the vitamins and minerals necessary for muscle maintenance and energy.
Photo by Andres Ayrton on Pexels.com

The Road to Sustainable Health

GLP-1 medications can be a valuable tool in your weight loss journey, but they should be part of a comprehensive approach that includes lifestyle changes and ongoing support. Here are some key takeaways for achieving sustainable health and weight loss:

  1. Consistency is Key: Regular exercise, balanced nutrition, and adherence to medication are crucial for long-term success.
  2. Holistic Approach: Consider your overall well-being, including mental health, stress management, and sleep, as part of your health journey.
  3. Stay Informed: Continuously educate yourself about your health, medications, and wellness strategies to make informed decisions.
  4. Healthy Eating: A balanced diet rich in whole foods, lean proteins, healthy fats, and complex carbohydrates supports overall health and complements the appetite-regulating effects of GLP-1 medications.
  5. Regular Exercise: Incorporating both aerobic and resistance exercises helps maintain muscle mass, boost metabolism, and improve cardiovascular health. This is particularly important as muscle mass can decrease with rapid weight loss if not adequately supported by exercise.
  6. Behavioral Changes: Addressing psychological and behavioral aspects of eating through counseling, mindfulness practices, or support groups can enhance the effectiveness of GLP-1 medications and contribute to long-term success.

Conclusion

While GLP-1 medications offer promising benefits for weight loss and diabetes management, they are not miracle drugs and should not be used lightly. Sustainable health and weight loss require hard work, dedication, and a holistic approach. Many times I try to utilize a natural approach prior to medications and have found that many people do well with this. By working with a knowledgeable healthcare provider and taking steps to maintain lean muscle mass, you can achieve and maintain your wellness goals. Remember, true health is a lifelong journey, and every step you take towards a healthier lifestyle is a step towards a better you.

Stay informed, stay healthy, and embrace the journey to your best self! 🌿✨

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Astrup, A., Carraro, R., Finer, N., Harper, A., Kunesova, M., Lean, M. E., … & Rossner, S. (2017). Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. International Journal of Obesity, 36(6), 843-854.

Buse, J. B., Wexler, D. J., Tsapas, A., Rossing, P., Mingrone, G., Mathieu, C., & D’Alessio, D. A. (2020). 2019 update to: Management of hyperglycemia in type 2 diabetes, 2018. Diabetes Care, 43(2), 487-493.

Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., … & Jendle, J. (2015). Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE Diabetes randomized clinical trial. JAMA, 314(7), 687-699.

Drucker, D. J. (2018). Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metabolism, 27(4), 740-756.

Holst, J. J., Rosenkilde, M. M., & Deacon, C. F. (2020). Pharmacology of incretin hormones with special reference to clinical pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. Pharmacological Reviews, 72(4), 604-648.

Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., … & le Roux, C. W. (2020). Semaglutide 2.4 mg for the treatment of obesity in adults: A systematic review and meta‐analysis. Diabetes, Obesity and Metabolism, 22(10), 1901-1911.

Lean, M. E., Astrup, A., Roberts, S. B., & Hanson, R. L. (2019). Making progress on the global crisis of obesity and weight management. The Lancet, 394(10215), 206-210.

Müller, T. D., Finan, B., Clemmensen, C., DiMarchi, R. D., & Tschöp, M. H. (2019). The new biology and pharmacology of glucagon-like peptide-1. Mayo Clinic Proceedings, 94(1), 51-67.

Wilding, J. P., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., … & Lau, D. C. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.