Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin (AMA 53 sneak peek)

ℹ️ EPISODE INFO

Released

September 18, 2023

Duration

27m

Channel

Peter Attia MD

Watch on YouTube

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📝 EPISODE DESCRIPTION

Watch the full episode and view show notes here: https://bit.ly/3QTSyqP Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ In this “Ask Me Anything” (AMA) episode, Peter explores various pharmacologic tools commonly utilized to improve metabolic health and treat diabetes, including SGLT-2 inhibitors, metformin, and GLP-1 agonists. He examines the available data on these drugs, assessing their comparative effectiveness and their potential in the context of lifestyle interventions. Additionally, he offers insights into whether SGLT2 inhibitors hold promise as geroprotective agents beyond their effects on glycemic control. Next, Peter analyzes the relationship between statin usage and the risk of developing insulin resistance and type 2 diabetes, investigating possible causal pathways and providing insights into strategies for risk reduction. He offers insights on monitoring adverse statin effects and evaluating the need for adjustments, ultimately weighing the trade-off between the risk to overall metabolic health against the benefits of reducing apoB levels through statin use. In this sneak peak, we discuss: 00:00 - Intro 00:10 - Pharmacologic tools for improving metabolic health, and the relationship between statins and insulin resistance 02:45 - SGLT-2 inhibitors: how they work and help to manage type 2 diabetes 09:10 - The history of SGLT2 inhibitors – from discovery to the current state 14:45 - Comparing the various FDA-approved SGLT2 inhibitors 20:37 - Other beneficial effects of SGLT2 inhibitors outside of glycemic control 23:32 - Exploring SGLT2 inhibitors as potential geroprotective molecules In the full episode, we also discuss: -The side effects and risks associated with SGLT2 inhibitors; -Medications, lifestyle interventions, and other considerations for treating diabetes and improving metabolic health; -Metformin as a tool for pre-diabetics, and how metformin compares to lifestyle interventions; -How GLP-1 agonists compare to metformin and SGLT2 inhibitors in terms of glycemic control and weight loss; -Exploring the relationship between statin use and the risk of developing insulin resistance and type 2 diabetes; -Possible mechanisms of statin-induced insulin resistance and diabetes, and potential mitigation strategies; -How to monitor for adverse effects of statin use and assess the need for adjustments; -Weighing the benefits and risks of statin use: does the diabetes risk outweigh the benefits of lowering apoB with a statin?; -Parting thoughts; and -More. -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/

🎤 SPEAKERS

• Peter Attia

  host

  Physician and host of "The Drive" podcast, focused on metabolic health and longevity medicine.

🧾 EPISODE SUMMARY

In this episode of Peter Attia MD, featuring Peter Attia, Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin (AMA 53 sneak peek) explores how SGLT-2 Inhibitors Work and Why Scientists Find Them Promising Attia uses a dresser-cleaning analogy to explain that the kidney filters everything out of plasma and then selectively reabsorbs what the body needs, which creates an opening to block glucose reabsorption.

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