Can GLP-1 weight loss medications help with Inflammatory Bowel Disease?

Patients with type 2 diabetes and IBD who are taking GLP-1 agonists or DPP-4 inhibitors may be at a lower risk for adverse clinical outcomes as a result of IBD.

January 9, 2023

GLP-1 Agonists are a class of medication that can help manage diabetes and help you lose up to 15% of your weight. Particularly prescribed to diabetic patients that are also obese, these medications include Ozempic, Wegovy, Mounjaro, Trulicity, Saxenda, and others! These medicines significantly improve the glycemic parameters and effectively reduce body weight. The elements work by activating GLP-1 receptors in the pancreas, which leads to better and  enhanced insulin release in the blood. As a result, the glucagon level also reduces, regulating the blood sugar level. Let’s find out how these medicines help with Inflammatory Bowel Disease!

Are these medications safe to take for patients with Inflammatory Bowel Diseases, like Crohn’s Disease and Ulcerative Colitis? In fact, they can help patients with these conditions!

You may be familiar with GLP-1 agonists for their ability to help manage diabetes and weight loss, but did you know they may also help patients who have inflammatory bowel diseases (IBD)? IBD is a group of disorders that include conditions like Crohn's Disease and Ulcerative Colitis.

Common IBD symptoms

  • Include abdominal pain, diarrhea, rectal bleeding, and anxiety/depression.
  • Patients may also have inflammation in other areas of their body like in the eyes, skin or joints.
  • Skin issues, including rashes, etc.
  • If the inflammation is not controlled for a long period of time, patients with IBD can develop narrowing of the colon from scar tissue formation (stricture), pockets of infection in the colon (abscess), or develop an abnormal passageway between colonic tissue and other tissue like the bladder or vagina. These long term complications are more rare and only develop if a patient does not receive proper treatment.

These symptoms may come and go, and are not consistent. But patients, more or less, experience these symptoms in the case of IBD.

IBD is diagnosed by a Gastroenterologist or “GI doctor”. Testing can involve many components including

  • Lab testing for inflammatory markers
  • Endoscopy and/or colonoscopy with biopsy
  • Stool sample analysis
  • Imaging like X-ray or CT scan

The doctor may advice colonoscopy as part of the ongoing monitoring of your IBD to check your inflammation levels and any signs of bowel cancer. This procedure is vital to prepare for any other severe health risks and consequences that may rise due to IBD.

IBD treatment can vary patient to patient and depends on the severity of disease. The treatment also depends on the severity of your symptoms and your medical history. It is vital to consult doctors and share your medical history, current medication, and active allergies before starting any kind of treatment. However, some common treatments can include:

  • Immunosuppressant medications
  • Anti-inflammatory medications
  • Oral steroids
  • Antibiotics
  • Surgery to remove diseased portion of colon
  • aminosalicylates or mesalazines – which can reduce inflammation in the gut.
  • Immunosuppressants, including steroids or azathioprine that inhibit the activity of the immune system and relieve IBD.
  • biological and biosimilar medicines – antibody-based medications given by injection that target a specific part of the immune system and treat IBD.

glp1 and inflammatory bowel disease

A recent study in Denmark showed that GLP-1 agonists may improve the disease course of IBD. This study was done in patients who had both Type 2 Diabetes and IBD and observed clinical outcomes in patients who were taking GLP-1 agonist or DPP-4 inhibitors, another type of glucose-lowering medication. Based on previous studies done in mice, researchers observed that GLP-1 agonists/DPP-4 inhibitors work to reduce inflammation in the gut, so they proposed that the same mechanism may occur in humans.

Highlights from the paper include:

  • Patients who were taking GLP-1/DPP-4 had statistically significantly lower rates of IBD-related hospitalization and use of steroids for IBD when compared to other antidiabetic drugs (199 events in patients taking GLP-1/DPP-4 vs 2,314 events patients taking other medications in a study population of 3,700).

  • GLP-1/DPP-4 medications work equally well in men and women to reduce the incidence of IBD-related complications.

  • GLP-1/DPP-4 medications work equally well for both UC and Chron’s Disease

Based on this study, patients with type 2 diabetes and IBD who are taking GLP-1 agonists or DPP-4 inhibitors may be at a lower risk for adverse clinical outcomes as a result of IBD.

Dr. Eva Shelton, M.D.

Harvard Medical School, Brigham and Women's Hospital

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