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ForumsMetabolic Health & DiabetesRemission of T2DM on GLP-1 — need advice

Remission of T2DM on GLP-1 — need advice

sean_dublin Sat, Oct 19, 2024 at 2:55 AM 27 replies 2,227 viewsPage 1 of 6
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sean_dublin
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Oct 19, 2024 at 4:20 AM#1

Remission of T2DM on GLP-1 — need advice

Posting this for discussion as it's directly relevant to our metabolic health & diabetes community. I'll summarize the key findings and then share my interpretation.

Background: Remission of T2DM on GLP-1 need has been a topic of significant interest. The latest data adds substantially to our understanding of the efficacy and safety profile in this area.

Key findings:

  • Primary endpoint met with statistical significance (p<0.001)
  • Effect size consistent with or exceeding Phase 2 projections
  • Adverse event profile in line with the known GLP-1 receptor agonist class effects — primarily GI (nausea 20-25%, diarrhea 12-17%)
  • Subgroup analyses showed benefit across BMI categories, age groups, and baseline metabolic status

My interpretation:

This is meaningful for several reasons. First, it confirms that the results from earlier-phase trials are reproducible at scale. Second, the safety data with longer follow-up is reassuring. Third, the subgroup consistency suggests this isn't driven by a specific patient phenotype.

I'd love to hear from others — especially those with clinical or research backgrounds. What are the limitations you see? What questions remain unanswered?

References:
[1] See thread title for study identification. Full citation available via PubMed/ClinicalTrials.gov.
— sean_dublin | Posted in Metabolic Health & Diabetes
40 15hannah_MT, Dr.SportsMedIN, amy_econ_NJ and 37 others
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NeuroNate
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Oct 19, 2024 at 4:37 AM#2
sean_dublin said:
Remission of T2DM on GLP-1 need advice

I respect sean_dublin perspective but I think this oversimplifies things a bit. Re: Remission of T2DM on GLP-1 — the effect size varies considerably by population.

I am not saying sean_dublin wrong entirely — just that the picture is more nuanced than a blanket statement. The SUSTAIN data specifically shows different outcomes in different metabolic phenotypes.

49 11wendy_avl, jason_paloalto, Dr.LeslieOBGYN and 46 others
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LarryQC_SD
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Oct 19, 2024 at 4:54 AM#3

+1 to sean_dublin. Especially the point about "Remission of T2DM on GLP-1 need advice..." — I have seen the same in my own experience with Remission of T2DM on.

Last edited: Oct 19, 2024 at 5:54 AM
42 0TinaHashiRN, robert_kc, dan_philly and 39 others
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PedsEndoPhilly
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Oct 19, 2024 at 5:11 AM#4

As a healthcare provider, I want to add some clinical context to this discussion on Remission of T2DM on GLP-1 need advice.

Building on what sean_dublin said — the evidence base here is well-established. The key publications to reference are from the FLOW program[1].

Key clinical points:

  1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
  2. Side effect profile is predictable and usually manageable with standard protocols
  3. Monitoring should include baseline labs and follow-up at 3-month intervals
  4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.

References:
[1] See thread title for relevant study identification.
Last edited: Oct 19, 2024 at 10:11 AM
49 19Dr.LeslieOBGYN, MikeNYC_runner and 46 others
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Dr.SleepRoch
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Oct 19, 2024 at 5:28 AM#5
LarryQC_SD said:
Especially the point about "Remission of T2DM on GLP-1 need advice

Gonna push back on this one. Remission of T2DM on GLP-1 need is not that straightforward in my experience. I have been on this for 18 months and the reality is messier than the trials suggest.

Don't get me wrong — the medication works. But adherence is harder than people admit. We should be honest about that.

41 14roxy_nash, tony_orlando, Dr.NephBHM_UK and 38 others
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