Benefits of Starting Mounjaro and Ozempic Early

Newer diabetes medications like Mounjaro (tirzepatide) and Ozempic (semaglutide) are some of the most effective treatments for type 2 diabetes available. But accessing them hasn’t always been easy, especially in the early days following an initial diagnosis.

“Metformin has been used as an effective first-line therapy for decades, and it's a fraction of the cost, so you're more likely to start with metformin than a GLP-1,” said Dr. Robert Gabbay, an endocrinologist and former chief scientific and medical officer of the American Diabetes Association (ADA).

While trying out less potent and less expensive options first makes sense for some, it probably isn’t the best choice for people with diabetes and other related health problems, like heart and kidney disease, who could benefit from the protective cardiorenal effects of newer diabetes medications. For many people with type 2 diabetes, medications like Mounjaro and Ozempic may be the best first-line option.

Why it’s important to treat diabetes early

Type 2 diabetes is a progressive disease. The longer it takes to find an effective strategy for managing your blood sugar, the more damage will accumulate in your body, and the harder it will be to treat.

That doesn’t just mean your cells will become more resistant to insulin or your pancreas will get more worn out. Everything in your body is connected, and an issue with one system or organ can cause or worsen problems with another. That’s why diabetes is frequently accompanied by other progressive disorders, including obesity, heart disease, kidney disease, and liver disease. These conditions are all easiest to treat if caught early.

To maintain your long-term health, it’s important to find a treatment strategy that addresses all of your issues. For instance, if you have heart disease and diabetes, then managing your blood sugar is only part of the solution; you need to make sure that whatever changes you’re making also help your heart.

Who can benefit from incretin therapies? 

Mounjaro and Ozempic are incretin-based therapies. The term incretin is sometimes used interchangeably with GLP-1 and GLP-1/GIP because most available incretin-based therapies were designed to mimic that hormone. Ozempic is a GLP-1 medication, and Mounjaro is the first one to mimic two hormones: GLP-1 and GIP. 

Incretin therapies were originally intended to help people manage their blood sugar, and they work very well for that purpose. Head-to-head comparisons with other diabetes medications consistently show that incretins are among the most effective options, making them a great choice for people who have high A1C values or spend a lot of time above range.

In addition, incretins are the most effective weight management medications available. There’s no better option for people who have obesity, which is currently defined as having a body mass index (BMI) of 30 or greater. 

Healthcare providers may also prescribe them for chronic obstructive sleep apnea and for weight management in people who have a BMI between 27 and 30 and at least one weight-related medical condition, including high blood pressure, high cholesterol, and type 2 diabetes.

The ultimate goal of treating obesity and diabetes is to make your whole body healthier. This is where incretins shine, with extensive evidence showing that they can significantly improve outcomes for people who have heart, kidney, and liver disease. There’s a growing consensus among experts that a person with diabetes with any of these other conditions should seriously consider taking an incretin as soon as they can.

Though these medications aren’t approved for prediabetes, studies have shown that these therapies can help people with prediabetes effectively manage their blood sugar. It might be more of a battle to get it covered by insurance, but Gabbay said that starting an incretin if you have prediabetes would be a reasonable choice, given that research has found 95% of people with prediabetes treated with Mounjaro reverted to normal blood sugar levels. 

When to start an incretin therapy

No two people are the same, and no two people with diabetes will be in the exact same situation when they first consider treatment options. So, the medication that your healthcare provider recommends as your first diabetes therapy will depend on the specifics of your health and circumstances.

Gabbay said that healthcare providers rely on guidelines like the ADA’s Standards of Care to help them make recommendations. Essentially, a provider has to consider how a person is doing with their blood sugar, whether they need any help meeting their weight management goals, and what other health conditions they are living with. It’s these factors, rather than how many other therapies you’ve tried or how long you’ve had diabetes, that should determine whether to start taking an incretin.

“Anyone who has the comorbidities of cardiovascular disease, kidney disease, or liver disease, it can actually be the first-line drug,” Gabbay said. “Also, based on weight management goals, someone living with obesity, that’s a reason in and of itself.”

If you already have obesity or heart, kidney, or liver disease, and you visit an endocrinologist or primary care practitioner who diagnoses you with type 2 diabetes, then they would be following the recommendations of the ADA and other medical organizations by sending you out of your initial appointment with a prescription for an incretin.

For people who don’t have those other conditions, it may make more sense to start with metformin and lifestyle changes, like getting exercise more regularly and eating a more health-conscious diet. These options may be enough for you to reach your blood sugar and body weight goals, but your healthcare provider should have you scheduled for a follow-up in three to six months, at which point you will review how successful the initial treatment plan has been. 

If you aren’t making progress towards your goals, then you may need to consider other options, and it’s never too early to start a conversation about incretins. Preliminary findings from an ongoing study have shown that, for people diagnosed with type 2 diabetes within the past four years who didn’t see results with metformin, adding Mounjaro to the treatment plan produced bigger drops in blood sugar and body weight than any other diabetes medication currently on the market.

The bottom line

The diabetes therapy that’s right for you will depend on your specific health concerns. Providers will make recommendations based on their understanding of your needs, but if they aren’t yet recommending an incretin, there’s no reason you can’t initiate the discussion.

“Bringing it up with your healthcare professional early on makes perfect sense. Have a conversation around it and keep revisiting that through your journey,” Gabbay said.

The most important thing is that you find a treatment strategy that helps you manage your diabetes and supports your overall health as quickly as you can.

Learn more about incretins and other diabetes medications here:

• How To Maximize Muscle Health on a GLP-1
• 7 Tips for Navigating Nausea on a GLP-1 Medicine
• Can a GLP-1 Quiet ‘Food Noise’?

This content was made possible with support from Eli Lilly and Company. Sponsored articles are independently written by diaTribe and are subject to our standard editorial and medical review process to ensure they meet our standards for quality, accuracy, and relevancy. Final editorial authority rests with diaTribe.