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A diferencia de los GLP1-RA, se ha observado en la evidencia clnica que los IDPP-4 no tienen beneficios cardiovasculares en pacientes con DM2 a pesar de contribuir en el control glucmico, por lo que no cumplen con los nuevos lineamientos en el tratamiento de la DM2, donde se busca reducir la incidencia de complicaciones ms all del control glucmico 58
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IGF-1 receptor differentially regulates spontaneous and evoked transmission via mitochondria at hippocampal synapses
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39 (3), e14700
Heres what I found: Bariatric surgery leads to greater, more durable weight loss and comorbidity reduction compared to GLP-1s GLP-1s offer substantial but less sustained comorbidity benefit with higher discontinuation rates (up to 50% at 35 yrs) GLP-1s do not eliminate the need for bariatric surgery in severe obesity Total weight loss trends higher for bariatric surgery, and real-world GLP-1 effectiveness is generally lower than clinical trial results (a significant finding that deserves its own post) Bariatric surgery is generally more effective than GLP-1s for long-term diabetes remission and cardiovascular risk reduction GLP-1s are associated with higher ongoing costs and are less cost-effective than bariatric surgery long-term The take home: GLP-1s are a valuable addition but dont replace bariatric procedures for patients with severe obesity or those requiring durable, substantial weight loss with co-morbidity reduction
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