The future of GLP-1 drugs in healthcare: Vital's role in enhancing metabolic treatment programs
Introduction
Today, GLP-1 drugs are most commonly used for diabetes and weight loss, but there is potential for GLP-1 therapies to transform healthcare by offering new solutions for managing chronic conditions.
More companies are incorporating these medications into their treatment programs, but given that this is a new landscape with both proven and emerging uses, companies must measure vital signs, monitor secondary effects, and integrate behavior change into their care plans as they transition patients off these drugs over time.
This article will look at what GLP-1s are, how they work for diabetes and weight loss, new GLP-1 uses in the treatment of other conditions, and how Vital can offer expertise and practical advice on optimizing GLP-1 programs with wearable data and lab testing.
Overview of GLP-1s
What are GLP-1s?
GLP-1 is a peptide hormone released in the small intestine and the colon within minutes of ingesting food. It activates receptors in the pancreas for blood sugar management by regulating insulin and inhibiting glucagon release. Insulin release helps the body’s cells take up sugar in the blood, thus lowering blood sugar levels.
GLP-1s also activate receptors in the hypothalamus area of the brain (the control center for hunger and thirst) to curb appetite. And in the gut, they reduce the speed at which the stomach empties after eating, known as gastric emptying, slowing the absorption of glucose into the blood and creating the feeling of being full last longer.
How do GLP-1s lead to weight loss?
Naturally occurring GLP-1 lasts only a few minutes in the body, but the drug form can last up to 14 hours, meaning that effects on appetite also last. So, taking a GLP-1 agonist can control a person’s cravings and make them feel fuller and less hungry for longer. It can also raise your resting metabolism.
GLP-1s show great results but work best for weight management as part of a comprehensive program that combines a nutritious diet, appropriate levels of exercise, healthy amounts of sleep, and stress management. Without these supporting behaviors, a patient will likely regain weight when they reduce dosage or stop taking the drug.
Economic considerations
A recent report by J.P. Morgan Research forecasts that the GLP-1 market will exceed $100 billion by 2030, driven equally by diabetes and obesity usage, and the number of GLP-1 users in the U.S. may number 30 million, which equates to 9% of the overall population.
To date, prescribed GLP-1s have been characterized by sky-high costs, especially as they have been affected by supply issues due to an increase in demand. An analysis by the Annals of Internal Medicine published in October 2022 found that the price of GLP-1s would need to drop by 90% to be considered reasonable for use as a first-line therapy. But potential future changes, such as the World Health Organization (WHO) designating liraglutide an ‘essential medicine’ in the 2025 update to the EML, could tip the balance towards cost effectiveness.
Three new use cases for GLP-1s
GLP-1 drugs were first licensed by the FDA in 2005 and have been prescribed for people with type 2 diabetes and obesity for almost 20 years. Since then, the mechanisms and benefits of GLP-1s have become better understood and revealed new opportunities where they could potentially be used in the treatment of additional conditions. Some of these are degenerative, and no current therapies are available, so the introduction of new and effective treatment options could provide patients with an improved quality of life.
GLP-1s are known to have positive cardiovascular effects, and better control of blood glucose levels through GLP-1 treatment has been shown to limit small blood vessel damage that can lead to health complications such as diabetic retinopathy. In addition, GLP-1s can lower blood pressure and limit the hardening of arteries, providing protective effects against major adverse cardiac events.
As the benefits of the GLP-1 receptor agonists with type 2 diabetes, obesity, and cardiovascular health have become widely known, research has accelerated, and potential new opportunities have risen to utilize GLP-1s to treat other conditions:
1. Nonalcoholic fatty liver disease (NAFLD)
Affecting more than 30% of people worldwide, NAFLD is caused by the build-up of lipids within hepatic cells and has been linked to obesity, type 2 diabetes, and hyperlipidemia. There are no symptoms or negative effects in early stages. Still, it may progress into more severe forms of liver disease, such as nonalcoholic steatohepatitis (NASH) or cirrhosis, if not addressed, both of which can lead to permanent damage and reduced liver function.
GLP-1s have emerged as a promising treatment to halt or even reverse the effects of NAFLD, largely due to the effects on weight loss and insulin secretion, but there is increasing evidence that GLP-1s may have more direct effects on the liver and benefits in the treatment of NAFLD. Phase 3 clinical trials into survodutide, a new GLP-1, showed it has the potential to combat NASH, one of the complications of NAFLD, with significant improvements seen in 83.0% of patients.
2. Alzheimer’s disease
Alzheimer’s is the most common cause of dementia and is an irreversible, slowly progressive condition often associated with cognitive decline, memory impairment, personality changes, and difficulty with motor skills and verbal communication.
Evidence suggests that GLP-1s are not only effective in preventing the accumulation of amyloid beta, a protein commonly associated with Alzheimer's, but also in mitigating the hyperphosphorylation and aggregation of tau, another critical protein in the disease's progression. Additionally, deficiencies in insulin availability are known to contribute to neurodegenerative conditions, but GLP-1s amplify insulin signaling in brain cells, increasing insulin sensitivity in the neurons.
In a six-month clinical trial, a GLP-1 drug called liraglutide was shown to slow the progression of the disease and improve the cerebral metabolic rate of glucose (CMRglc), which is a measurement of glucose metabolism in the brain important for normal cognitive function. More research is required, but this is promising.
3. Alcohol dependency
Addiction is related to the reward-related dopamine levels that are present in the nervous system, and alcohol consumption acts on these reward-related areas, causing an increase in the release of dopamine.
More research is necessary, but study results show GLP-1s potentially suppress alcohol-induced accumbal dopamine release, prevent the effects of alcohol deprivation, and reduce alcohol intake, the impact of alcohol withdrawal, and relapse in patients living with an alcohol addiction.
Key industry players
Novo Nordisk, Eli Lilly, AstraZeneca and Sanofi lead the charge in GLP-1 drugs. There are currently eight types available to treat type 2 diabetes, each administered either as oral or injectable medications:
To date, FDA approval has only been granted to two of Novo Nordisk’s GLP-1s to be used as a weight loss drug. The semaglutide Wegovy and also the liraglutide Saxenda, a once-daily injection used solely for weight management.
However, competition is emerging in the form of danuglipron, a GLP-1 pill from Pfizer. An ongoing study is evaluating the pharmacokinetics, safety, and dose optimization, but it is likely to be administered orally once-daily.
How key health companies are running GLP-1 programs
The market is definitely shifting, and companies in the space are looking to adapt their strategies to incorporate a more medical approach. Some key players in the weight loss industry are making GLP-1s part of their offering:
Noom aims to help you understand and manage the way you think about your food intake so that while you lose weight, you’re developing sustainable lifestyle changes. They have recently introduced Noom Med, a personalized clinical support program built on top of their existing psychology-based program.
Ro’s body program combines GLP-1 medication with 1:1 personal coaching and 12 months of curriculum and support to help lose weight and keep it off.
This weight loss program is a customized, medically supervised online membership program with a holistic approach. Found incorporates diet, lifestyle, and prescription GLP-1s, plus the program is said to consider genetics and hormonal differences as well.
How Vital helps companies manage metabolic programs
Vital’s Wearables and Lab Testing API allows health and wellness companies to personalize their care plans and provide more effective treatment. Data from wearables and medical devices are fed directly into their apps, and this data allows them to track lifestyle changes and encourage habit formation, building toward sustainable behavior modifications that maximize the long-term success of GLP-1 programs. Vital manages the lab relationships, eliminating the time your team needs to spend chasing down exceptions or missing results.
For example, Vital’s Apple Health integration has helped users track their meal and nutrition data. With greater visibility into key biomarkers like sleep, activity, and heart rate, users are better able to measure their advancement toward their goals. Being able to visualize progress in this way helps to monitor progress and reinforce positive behavior changes.
Another example is Fastic, an intermittent fasting app that offers personalized weight loss support. They found that users leveraging their wearables via Vital’s Wearables API achieved their weight loss goals 24% faster than those who didn't. The additional longitudinal data also gave their clinicians more data, so they could better tailor fasting plans, ultimately leading to higher user success rates and better adherence to the program.
Vital’s collaboration with Light-it
Light-it is a digital health product agency developing healthcare software solutions. Vital takes care of the technical integration, and then Light-it steps in to design and develop a user-friendly, engaging app that makes the most of this data.
The team at Light-it specializes in creating digital health solutions that not only function efficiently but also provide an intuitive and personalized experience for the end user. By leveraging Vital’s integrated data, Light-It can provide clients with a tailored app that includes:
- Personalized health dashboards: Clients can monitor their health metrics in real-time, with insights tailored to their individual profiles, enabling informed health decisions.
- Predictive analytics: Utilizing data science, the app would offer predictive insights, such as identifying potential health risks based on trends in client data, allowing for proactive measures.
- Behavioral nudges: The app could feature reminders or motivational prompts tailored to the client’s activity and health goals to encourage healthier habits.
- Gamification and rewards: To boost engagement, gamified features like challenges and rewards for meeting health objectives could be included, potentially integrated with the insurance company’s incentive programs.
- Secure data management: Ensuring personal health data is handled securely and in compliance with regulations such as HIPAA to maintain the highest standards of privacy and security.
Looking to personalize your metabolic program?
GLP-1s are already proving their mettle in the weight loss arena when combined with lifestyle changes. If you’re a company in the weight management space, wearables data could be powerful in helping personalize your programs, ultimately improving user engagement and long-term results.
Sign up for a demo to discover how Vital’s API can help you leverage wearables data and lab testing to personalize programs at scale, minimize operations work chasing down lab results, and reduce engineering costs spent building point-to-point wearable or lab integrations.