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All right.

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Welcome to the

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next installment of

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Live Well with UCI Health.

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I'm Ryan Manno from

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KOST 103.5 The Ellen K Morning Show

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and iHeart Radio.

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I am sitting here

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with three distinguished doctors.

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We will go down the line and have,

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have you guys introduce yourselves

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and what you do here at UCI Health.

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Hey, thanks for having us on. Yeah.

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My name is Andy Lee.

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I'm one of the heart failure

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cardiologists at UC Irvine.

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I've been here about five years.

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I also have a

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distinct interest

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in cardio metabolic health as well.

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And I'm very happy to be here.

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Great.

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My name is Qin Yang.

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I'm one of the endocrinologist 

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here at UCI Health

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and I serve as the endocrinology chief

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and, also, diabetes center director.

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Okay.

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It's a real pleasure

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to be with you today.

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My name is Nathan Wong.

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I'm a

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cardiovascular epidemiologist and a

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specialist in preventive cardiology

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and a professor and director

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of the heart disease

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prevention program here

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at UCI

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and also co-director

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of our center

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for Global Cardiometabolic

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Health and Nutrition.

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Quite impressive this resume.

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And look,

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we're going to get into something

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that,

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I'm very excited about this topic.

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And I just want to start

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by by saying

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because we're going to talk about

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GLP-1s medications

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like Ozempic, Wegovy, Mounjaro,

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Zepbound.

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I am a GLP-1 user,

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so I'm

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very like I'm

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very intrigued by what

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we're going to dig into today.

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Specifically, you know,

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I feel like in the last,

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I don't know, a year

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and a half, two years,

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these things

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have really just exploded.

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People are excited about them.

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I know that

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we're still learning about them.

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There's still a lot of questions,

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maybe some doubts.

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So we'll we'll try and dig

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into all of this today.

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Doctor Yang,

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what are these medications

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and why is everyone so

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jazzed about this? Right.

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So GLP-1, actually, is a hormone,

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gut hormone.

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You know,

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everybody makes GLP-1

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You and me, everybody sitting here,

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actually,

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makes a little bit

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GLP-1, right now, even

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however, after you eat,

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you will make more GLP-1

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The proposal for that is to,

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help the pancreas

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make up more insulin

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That's a primary function.

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Now the GLP-1 drugs

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are a bit different

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from the hormone we make.

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Okay, so it's a modified

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GLP-1

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It's more powerful, more strong,

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and then caused significant

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weight loss.

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That's the benefit of these drug

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versus indulgence hormone okay.

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So very excited about this

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because there are several reasons.

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One is

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as I said, a very powerful

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medication for weight loss.

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The second has to do

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with, tolerability,

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meaning most people

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can tolerate this drug

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as you all use you right now

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probably have experience.

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So not a lot of side effects.

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Some side effects.

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Not a lot.

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Yeah.

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That's why we're excited about it.

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And it's also helping people

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I mean look the weight loss

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thing is tremendous right.

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I think that's probably why

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a lot of people are into it.

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But you know,

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there are other things

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that we will talk about.

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But specifically

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it's helping a lot with,

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with managing diabetes.

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How does that work? Right.

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So as I mentioned, so,

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the endogenous

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GLP-1

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we make

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helps the pancreas

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to make more insulin. Right.

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You got it.

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So that's one reason.

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It lowers sugar, but

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the drugs are so powerful because,

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in addition to the pancreas,

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the drugs also work on the brain

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and the gut.

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So in the brain,

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these drugs

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suppresses the appetite.

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So you don't feel hungry? Yeah.

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In the gut,

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it slows down the movement.

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So the nutrients, absorption

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will be slow down.

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And the all together

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would be very powerful

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to cause weight loss

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and also improve diabetes.

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How much weight?

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So if someone's

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watching this, listening

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to this and,

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you know,

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they're on the fence about this,

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how much weight

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do you see on average

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a person typically losing

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or can they lose. Right.

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This is quite a variable actually.

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So from the clinical trials

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it's around 10 to 20%

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depending on patient population,

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what kind of drugs

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the patients are using

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in the real world.

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Yes very variable.

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Some people can lose

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a lot of weight for my patients.

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You know I see patients

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losing 100 pounds.

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Yeah it happens

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but it's some people just lose

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10 pounds.

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15 pounds is bearable.

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Do you find that

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the initial weight loss

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is greater than the sustained

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weight loss.

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Like does it

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does it hit

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early and a lot right up front

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and then kind of slow down?

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It's true.

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But we do

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what's called a dose escalation.

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So, we start with a smaller

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dose, gradually increase the dose.

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So we usually, reach the highs,

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the dose, where you can tolerate.

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Yes.

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And you

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peak your weight loss,

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and then we maintain that.

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Those. Yeah.

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Doctor Wong, what

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additional health benefits

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are you seeing,

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with these GLP-1 medications?

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So having been in the

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cardiovascular disease

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prevention field for,

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for some 40 years, I'm,

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very excited

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about the ability

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of these drugs to, improve,

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to improve cardiovascular outcomes

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and so we've published, several,

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several studies that involve

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Wegovy,

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as well as Zepbound.

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And we've estimated that 93

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million U.S.

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adults may be eligible for

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for these therapies.

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And, and besides,

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reducing obesity prevalence

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by up to 55 million

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in the United States,

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we found that,

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look, you know,

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you know,

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we know that these therapies,

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significantly reduce

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blood pressure,

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by about ten points,

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systolic blood pressure.

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They also,

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improve

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both the good cholesterol,

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HDL cholesterol by about 10%.

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They reduced the bad

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LDL cholesterol by about 10%.

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They also reduced triglycerides

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by about 30%.

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And because inflammation is also

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a major cause

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of cardiovascular disease,

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they reduce

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levels of an inflammatory

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measure called

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C-reactive protein

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by up to about 50%.

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And when you put all these risk

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factor changes together, we've

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estimated that,

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that

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one may see a reduction

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of about 18%

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in their

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risk of cardiovascular disease,

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such as on Wegovy, up to about 24%

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on Zepbound potentially prevent

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in between 1.5

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million and 2 million

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cardiovascular events

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over a span of ten years.

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So,

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so I'm very excited about,

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these effects.

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We also know that,

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there's some evidence that,

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that these drugs may even,

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reduce risk of Alzheimer's disease

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and can be effective in

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treating sleep apnea.

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And, and we'll talk about later,

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but also, prevention of diabetes.

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Right.

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So individuals

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with overweight and obesity,

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one of their biggest risk besides,

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cardiovascular disease

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being their leading

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cause of death

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is the development of diabetes.

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But we know that these, therapies,

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from one

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major clinical trial called SELECT,

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which involved Wegovy, reduce

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diabetes incidence by over 70%.

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Wow.

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That is incredible.

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So,

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Doctor Wong just touched on

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on the cardiovascular thing.

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Doctor Lee,

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what about patients

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suffering from heart failure?

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Yeah, like, this is, I think,

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one of the most

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exciting parts about these

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GLP-1 family of drugs.

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Just to expand on

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what Doctor Wong was talking about,

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you have these obesity

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related conditions

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that could be potentially treated.

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And when you overlap,

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like the treatment of both obesity

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and say,

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for example,

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heart failure or sleep apnea,

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these obesity

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really conditions then,

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these patients can get better.

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So in particular

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for congestive heart failure,

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this is a bit

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more of a nuanced conversation.

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But just to keep it simple,

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we now can kind of subdivide

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our filter into those

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with normal heart function,

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those with weak heart function.

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And in this

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particular case,

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we're talking about patients

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with normal

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or preserved ejection

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fraction or heart function.

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So when you take these patients

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who have

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obesity related

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heart failure with preserved

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ejection fraction,

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they have shown,

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through these different medications

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with Semaglutide

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with Tirzepatide. So either with

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Zepbound or with

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Wegovy there's

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actually a benefit in terms

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of how these patients do

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and in terms

00:09:07:00 - 00:09:09:23

of symptoms, quality of life,

00:09:09:23 - 00:09:11:01

ability to walk.

00:09:11:01 - 00:09:12:10

And then,

00:09:12:10 - 00:09:13:19

actually reducing their heart

00:09:13:19 - 00:09:15:19

failure hospitalizations.

00:09:15:19 - 00:09:17:02

So we're really expanding

00:09:17:02 - 00:09:17:17

these indication

00:09:17:17 - 00:09:18:14

of these medications.

00:09:18:14 - 00:09:20:21

And now cardiologists are in fact

00:09:20:21 - 00:09:22:02

comfortable prescribing

00:09:22:02 - 00:09:22:17

GLP-1s

00:09:22:17 - 00:09:24:19

for a myriad of different reasons.

00:09:24:19 - 00:09:25:01

Right.

00:09:25:01 - 00:09:27:03

And one of those can be heart failure

00:09:27:03 - 00:09:29:07

with preserved ejection fraction.

00:09:29:07 - 00:09:30:01

So more to come.

00:09:30:01 - 00:09:30:19

You know,

00:09:30:19 - 00:09:32:02

I think we need more data

00:09:32:02 - 00:09:33:15

to really know for sure

00:09:33:15 - 00:09:36:00

exactly what we're treating there.

00:09:36:00 - 00:09:38:14

There's various theories.

00:09:38:14 - 00:09:40:12

Some of these theories do involve

00:09:40:12 - 00:09:41:21

like visceral adiposity.

00:09:41:21 - 00:09:43:03

So in patients

00:09:43:03 - 00:09:43:17

with

00:09:43:17 - 00:09:44:23

Obesity Metabolic Syndrome

00:09:44:23 - 00:09:47:08

like they may actually have

00:09:47:08 - 00:09:48:03

fat cells

00:09:48:03 - 00:09:48:22

building up around

00:09:48:22 - 00:09:49:17

the visceral organs

00:09:49:17 - 00:09:50:15

such as the heart.

00:09:50:15 - 00:09:51:19

And by reducing

00:09:51:19 - 00:09:53:12

that visceral adiposity, it's

00:09:53:12 - 00:09:54:15

thought that it may

00:09:54:15 - 00:09:57:07

help with heart function. So,

00:09:57:09 - 00:09:57:22

more to come.

00:09:57:22 - 00:09:58:07

You know, we

00:09:58:07 - 00:09:59:04

still have a lot to learn,

00:09:59:04 - 00:10:00:12

but it's extremely exciting.

00:10:00:12 - 00:10:01:03

Yeah,

00:10:01:03 - 00:10:02:06

I know snoring at night

00:10:02:06 - 00:10:03:04

is different than sleep apnea,

00:10:03:04 - 00:10:03:16

but you guys have

00:10:03:16 - 00:10:04:13

mentioned snoring.

00:10:04:13 - 00:10:05:07

I have found okay.

00:10:05:07 - 00:10:06:16

So I track my sleep with this app.

00:10:06:16 - 00:10:07:07

Okay.

00:10:07:07 - 00:10:09:03

I have noticed in the last year

00:10:09:03 - 00:10:10:22

that I've been on these my snoring.

00:10:10:22 - 00:10:11:20

Is that a thing?

00:10:11:20 - 00:10:13:04

Am I not making this up?

00:10:13:04 - 00:10:14:07

I mean I my snoring has gone

00:10:14:07 - 00:10:15:07

from like an hour

00:10:15:07 - 00:10:16:01

and a half or two hours

00:10:16:01 - 00:10:18:02

a night to like two minutes.

00:10:18:02 - 00:10:19:15

Is that is that part of this?

00:10:19:15 - 00:10:20:03

Yeah.

00:10:20:03 - 00:10:23:00

It's, you know, FDA approved,

00:10:23:00 - 00:10:24:23

Zepbound for the sleep apnea.

00:10:24:23 - 00:10:25:22

Yeah. So.

00:10:25:22 - 00:10:26:15

And how.

00:10:26:15 - 00:10:27:08

I'm sorry,

00:10:27:08 - 00:10:29:01

I'm taking us off course, but

00:10:29:01 - 00:10:30:06

how similar is snoring

00:10:30:06 - 00:10:31:01

to sleep apnea?

00:10:31:01 - 00:10:32:06

Are they in the same family of

00:10:32:06 - 00:10:34:10

of behaviors. No no no no. Okay.

00:10:34:10 - 00:10:36:01

So snoring just the snore.

00:10:36:01 - 00:10:36:12

Right, right.

00:10:36:12 - 00:10:37:17

But, so why is my snoring

00:10:37:17 - 00:10:39:05

going down on GLP ones?

00:10:39:05 - 00:10:39:16

What? Sleep.

00:10:39:16 - 00:10:40:16

And I've lost weight

00:10:40:16 - 00:10:41:14

is that there's stuff

00:10:41:14 - 00:10:42:16

that, you know,

00:10:42:16 - 00:10:43:04

sleep apnea,

00:10:43:04 - 00:10:44:21

a snoring can be due to,

00:10:44:21 - 00:10:45:23

neck circumference. Right.

00:10:45:23 - 00:10:48:14

And, that's potentially modifiable.

00:10:48:14 - 00:10:49:09

Yes. Right.

00:10:49:09 - 00:10:51:16

That may help. Okay I love it.

00:10:51:16 - 00:10:51:21

Yeah.

00:10:51:21 - 00:10:53:13

Sleep apnea, you have to have

00:10:53:13 - 00:10:54:07

stop breathing

00:10:54:07 - 00:10:55:10

for a period of time. Yeah.

00:10:55:10 - 00:10:57:11

Okay. Above the, snoring.

00:10:57:11 - 00:10:57:21

Okay.

00:10:57:21 - 00:10:58:18

See, I have a bunch of my own

00:10:58:18 - 00:10:59:10

personal questions.

00:10:59:10 - 00:11:00:04

I'm just trying to keep us

00:11:00:04 - 00:11:02:11

on track. Doctor Lee, back to you.

00:11:02:11 - 00:11:03:15

So you are involved

00:11:03:15 - 00:11:05:01

in clinical trials, right?

00:11:05:01 - 00:11:06:16

For for various things.

00:11:06:16 - 00:11:07:14

What specifically

00:11:07:14 - 00:11:08:21

are you involved in?

00:11:08:21 - 00:11:09:15

I don't know now.

00:11:09:15 - 00:11:09:23

Or what's

00:11:09:23 - 00:11:11:01

what's an exciting one

00:11:11:01 - 00:11:12:23

that you can talk about? Oh, yeah.

00:11:12:23 - 00:11:14:19

So both me and,

00:11:14:19 - 00:11:16:01

Doctor Nathan Wong are involved

00:11:16:01 - 00:11:18:02

with the Tirzepatide trial

00:11:18:02 - 00:11:19:09

for cardiovascular outcomes

00:11:19:09 - 00:11:20:03

here at UCI.

00:11:20:03 - 00:11:21:18

We're one of the sites,

00:11:21:18 - 00:11:23:00

and this international study,

00:11:23:00 - 00:11:23:19

and I'm the site

00:11:23:19 - 00:11:25:08

primary investigator.

00:11:25:08 - 00:11:26:00

So the

00:11:26:00 - 00:11:26:07

I guess

00:11:26:07 - 00:11:28:08

the name for this trial is

00:11:28:08 - 00:11:30:03

surmount MMO.

00:11:30:03 - 00:11:31:10

But it's extremely exciting

00:11:31:10 - 00:11:32:06

to be a part of this trial

00:11:32:06 - 00:11:33:01

because then,

00:11:33:01 - 00:11:33:08

you know,

00:11:33:08 - 00:11:34:10

we were able

00:11:34:10 - 00:11:36:00

to start with Tirzepatide

00:11:36:00 - 00:11:36:21

when it was still,

00:11:36:21 - 00:11:37:07

you know,

00:11:37:07 - 00:11:38:02

sort of up and coming

00:11:38:02 - 00:11:40:07

just had gotten approved by FDA.

00:11:40:07 - 00:11:41:08

They had ongoing trials

00:11:41:08 - 00:11:42:10

with diabetes.

00:11:42:10 - 00:11:43:16

But those results released

00:11:43:16 - 00:11:45:02

at the time of enrollment

00:11:45:02 - 00:11:46:09

when we were starting up,

00:11:46:09 - 00:11:47:06

now we're about three years

00:11:47:06 - 00:11:48:00

into it.

00:11:48:00 - 00:11:49:14

So we've recruited some patients.

00:11:49:14 - 00:11:51:23

We've kind of followed them out.

00:11:52:01 - 00:11:53:17

We've been able to see,

00:11:53:17 - 00:11:56:23

you know, some, let's say isolated,

00:11:57:01 - 00:11:59:18

patient benefits and, from there

00:11:59:18 - 00:12:00:23

contributing to the science

00:12:00:23 - 00:12:02:02

and seeing overall,

00:12:02:02 - 00:12:04:05

how does this medication actually.

00:12:04:05 - 00:12:06:00

Benefit cardiovascular patients?

00:12:06:00 - 00:12:07:06

You know, like in this case,

00:12:07:06 - 00:12:09:03

we're not really treating obesity.

00:12:09:03 - 00:12:11:09

We're treating patients with either

00:12:11:09 - 00:12:12:06

a high risk

00:12:12:06 - 00:12:13:04

for having heart disease

00:12:13:04 - 00:12:13:17

or they already have

00:12:13:17 - 00:12:15:09

existing heart disease or,

00:12:15:09 - 00:12:16:23

some other cardiovascular disease

00:12:16:23 - 00:12:17:13

such as stroke

00:12:17:13 - 00:12:19:05

or something like that.

00:12:19:05 - 00:12:22:01

So really, you know, this

00:12:22:01 - 00:12:22:14

this is going

00:12:22:14 - 00:12:24:06

to sort of expand the,

00:12:24:06 - 00:12:24:22

label indication

00:12:24:22 - 00:12:25:21

of this medicine, right?

00:12:25:21 - 00:12:26:11

Because right now

00:12:26:11 - 00:12:28:05

this is approved for diabetes,

00:12:28:05 - 00:12:29:15

it's approved for sleep apnea

00:12:29:15 - 00:12:30:17

and for weight loss.

00:12:30:17 - 00:12:33:06

It's not yet approved for,

00:12:33:06 - 00:12:35:04

reducing cardiovascular risk.

00:12:35:04 - 00:12:37:00

But you want to get there.

00:12:37:00 - 00:12:37:23

We're contributing to that.

00:12:37:23 - 00:12:39:10

Yeah, I love that. Yeah.

00:12:39:10 - 00:12:41:16

And I might also add that,

00:12:41:16 - 00:12:45:01

so the Surmount MMO trial that

00:12:45:03 - 00:12:46:19

doctor Lee just mentioned

00:12:46:19 - 00:12:48:20

this is going to be

00:12:48:22 - 00:12:50:03

very important

00:12:50:03 - 00:12:54:04

in particular because unlike the

00:12:54:06 - 00:12:57:10

earlier SELECT trial that involved

00:12:57:12 - 00:12:59:01

Wegovy

00:12:59:01 - 00:13:00:06

Surmount MMO

00:13:00:06 - 00:13:02:12

is also included in people

00:13:02:12 - 00:13:04:06

without pre-existing

00:13:04:06 - 00:13:05:17

cardiovascular disease,

00:13:05:17 - 00:13:08:01

but have overweight and obesity.

00:13:08:01 - 00:13:10:09

So it's going to really answer

00:13:10:09 - 00:13:12:00

the important question, right,

00:13:12:00 - 00:13:14:08

of whether or not these,

00:13:14:08 - 00:13:16:03

therapies can

00:13:16:03 - 00:13:17:08

improve,

00:13:17:08 - 00:13:19:19

cardiovascular outcomes in,

00:13:19:19 - 00:13:21:16

you know, a much larger

00:13:21:16 - 00:13:23:02

proportion of patients

00:13:23:02 - 00:13:25:13

who don't have preexisting

00:13:25:13 - 00:13:26:20

cardiovascular disease.

00:13:26:20 - 00:13:28:18

Yeah, that's that's awesome.

00:13:28:18 - 00:13:30:09

Doctor Yang, let's, you know,

00:13:30:09 - 00:13:30:21

I think,

00:13:30:21 - 00:13:33:10

I think that one of the concerns

00:13:33:10 - 00:13:35:01

for anyone would be side effects.

00:13:35:01 - 00:13:35:11

And that's true

00:13:35:11 - 00:13:36:16

of any medication, right?

00:13:36:16 - 00:13:37:18

You you watch TV

00:13:37:18 - 00:13:38:22

and the list of side effects

00:13:38:22 - 00:13:40:05

is longer than the commercial

00:13:40:05 - 00:13:41:09

or possible side effects.

00:13:41:09 - 00:13:43:09

What can we expect

00:13:43:09 - 00:13:44:18

in terms of side effects

00:13:44:18 - 00:13:46:09

from these medications? Right.

00:13:46:09 - 00:13:48:22

So overall, as I mentioned,

00:13:48:22 - 00:13:51:10

they are reasonably tolerable. Yes.

00:13:51:10 - 00:13:52:02

It's probably

00:13:52:02 - 00:13:53:18

from your experience to now,

00:13:53:18 - 00:13:55:08

there are two major side effects

00:13:55:08 - 00:13:56:01

I want to mention.

00:13:56:01 - 00:13:56:14

The first one,

00:13:56:14 - 00:13:58:16

of course is GI the stomach. Okay.

00:13:58:16 - 00:14:00:11

So it slows down the stomach.

00:14:00:11 - 00:14:01:23

You know, you feel full,

00:14:01:23 - 00:14:03:20

bloated constipation.

00:14:03:20 - 00:14:05:02

Some people have diarrhea

00:14:05:02 - 00:14:07:13

occasion vomiting. It happens.

00:14:07:13 - 00:14:09:10

So so to attack that

00:14:09:10 - 00:14:09:23

that's why

00:14:09:23 - 00:14:11:22

we do the dose escalation

00:14:11:22 - 00:14:13:02

from a smaller dose

00:14:13:02 - 00:14:13:20

that your stomach

00:14:13:20 - 00:14:15:04

could get used to that.

00:14:15:04 - 00:14:16:11

And then we use a higher dose

00:14:16:11 - 00:14:19:01

to achieve the therapeutic effects.

00:14:19:01 - 00:14:22:09

The second I want to suggest is to,

00:14:22:11 - 00:14:25:08

eat, digest, easy to digest food

00:14:25:08 - 00:14:27:19

if you eat, eat greasy food

00:14:27:19 - 00:14:28:13

that digest in

00:14:28:13 - 00:14:30:04

slow down from beginning

00:14:30:04 - 00:14:31:18

then medication add to that.

00:14:31:18 - 00:14:33:06

Then you would have more,

00:14:33:06 - 00:14:34:20

stomach side effects. Right?

00:14:34:20 - 00:14:35:21

So these are two things

00:14:35:21 - 00:14:37:12

I would do to help with that

00:14:37:12 - 00:14:39:03

GI side effects.

00:14:39:03 - 00:14:41:12

Now second to major side effect is,

00:14:41:12 - 00:14:42:12

is quite interesting.

00:14:42:12 - 00:14:44:12

It's called, lean

00:14:44:14 - 00:14:46:17

muscle mass loss.

00:14:46:17 - 00:14:48:09

So it's a big one.

00:14:48:09 - 00:14:50:10

It's an active research,

00:14:50:10 - 00:14:52:11

interest for a lot of people.

00:14:52:11 - 00:14:53:19

So say you use a medication,

00:14:53:19 - 00:14:55:15

you lose 10 pounds right

00:14:55:15 - 00:14:57:04

an amount of 10 pounds,

00:14:57:04 - 00:14:59:00

7 pounds of fat mass.

00:14:59:00 - 00:14:59:07

Okay.

00:14:59:07 - 00:15:00:03

And 3 pounds

00:15:00:03 - 00:15:01:18

will be your muscle mass.

00:15:01:18 - 00:15:02:22

And I want you don't want that.

00:15:02:22 - 00:15:03:06

Right.

00:15:03:06 - 00:15:04:19

So if you lose

00:15:04:19 - 00:15:06:08

a lot of muscle mass.

00:15:06:08 - 00:15:09:03

you will feel weaker and fatigued

00:15:09:03 - 00:15:10:15

So, we encourage

00:15:10:15 - 00:15:12:17

people to take some protein. Yeah.

00:15:12:17 - 00:15:14:13

Take a protein powder

00:15:14:13 - 00:15:16:22

and also encourage them to exercise

00:15:16:22 - 00:15:17:12

Very important

00:15:17:12 - 00:15:19:00

to keep that muscle mass. Sure.

00:15:19:00 - 00:15:20:14

Otherwise you'll feel weaker.

00:15:20:14 - 00:15:21:02

Yeah.

00:15:21:02 - 00:15:22:09

Now, there are some side

00:15:22:09 - 00:15:25:08

effects are less common.

00:15:25:08 - 00:15:27:01

But, we usually consult

00:15:27:01 - 00:15:28:09

with patients

00:15:28:09 - 00:15:29:19

like pancreatitis,

00:15:29:19 - 00:15:31:10

gallbladder issues.

00:15:31:10 - 00:15:33:03

We usually screen them before

00:15:33:03 - 00:15:34:09

starting their medications.

00:15:34:09 - 00:15:35:03

We don't use them

00:15:35:03 - 00:15:35:17

if they have

00:15:35:17 - 00:15:37:08

preexisting conditions.

00:15:37:08 - 00:15:39:01

But even without those conditions,

00:15:39:01 - 00:15:41:08

we need to watch those carefully.

00:15:41:08 - 00:15:42:19

There was one that I

00:15:42:19 - 00:15:45:03

just from another personal,

00:15:45:05 - 00:15:45:23

you know, aspect.

00:15:45:23 - 00:15:47:13

When I started, I did notice, like,

00:15:47:13 - 00:15:49:02

some nausea, the first,

00:15:49:02 - 00:15:49:12

you know,

00:15:49:12 - 00:15:51:11

the first couple injections,

00:15:51:11 - 00:15:52:00

I think they

00:15:52:00 - 00:15:53:08

they gave me Zofran two for it,

00:15:53:08 - 00:15:54:08

and it took it right away,

00:15:54:08 - 00:15:55:08

and that didn't last long.

00:15:55:08 - 00:15:56:02

It you know,

00:15:56:02 - 00:15:56:20

you hear about that, you're like,

00:15:56:20 - 00:15:58:04

oh, God, am I going to walk around

00:15:58:04 - 00:15:59:07

life nauseous? No.

00:15:59:07 - 00:16:00:18

It goes it's

00:16:00:18 - 00:16:01:14

it's you're

00:16:01:14 - 00:16:02:08

you're getting used to it.

00:16:02:08 - 00:16:03:19

Yeah. Exactly. Yeah. Yeah.

00:16:03:19 - 00:16:06:06

I might also add,

00:16:06:06 - 00:16:09:00

perhaps add that, you know, to,

00:16:09:00 - 00:16:10:12

Doctor Yang's comments,

00:16:10:12 - 00:16:10:20

you know,

00:16:10:20 - 00:16:12:23

regarding the potential

00:16:12:23 - 00:16:15:07

loss of lean muscle mass.

00:16:15:07 - 00:16:15:19

It, you know,

00:16:15:19 - 00:16:18:19

we really encourage patients,

00:16:18:20 - 00:16:19:23

you know, in addition

00:16:19:23 - 00:16:21:14

to general exercise,

00:16:21:14 - 00:16:22:21

but in particular

00:16:22:21 - 00:16:24:19

strength training. Sure.

00:16:24:19 - 00:16:27:13

So perhaps, you know, in doing,

00:16:27:13 - 00:16:29:03

doing a little bit of weights

00:16:29:03 - 00:16:31:08

would, would be worthwhile.

00:16:31:08 - 00:16:33:14

And, and one,

00:16:33:14 - 00:16:35:09

very interesting side effect.

00:16:35:09 - 00:16:36:13

Maybe it's a good thing

00:16:36:13 - 00:16:39:21

that was recently reported,

00:16:39:23 - 00:16:42:17

was perhaps,

00:16:42:17 - 00:16:47:05

less of a desire for alcohol use.

00:16:47:07 - 00:16:50:07

So maybe it's reducing,

00:16:50:12 - 00:16:52:11

potentially reducing people's

00:16:52:11 - 00:16:54:17

intake of alcohol, like the,

00:16:54:17 - 00:16:56:17

the desire or the ability,

00:16:56:17 - 00:16:58:18

perhaps both. Okay. Yeah.

00:16:58:18 - 00:17:00:14

Got it. Interesting.

00:17:00:14 - 00:17:01:17

This is a totally off

00:17:01:17 - 00:17:03:17

the page one again

00:17:03:17 - 00:17:06:09

and tell me I'm crazy.

00:17:06:11 - 00:17:07:05

I feel like

00:17:07:05 - 00:17:07:16

because I did

00:17:07:16 - 00:17:08:14

stop them for a little bit,

00:17:08:14 - 00:17:11:01

and I feel like it helped my mood,

00:17:11:01 - 00:17:12:20

and that could be the

00:17:12:20 - 00:17:14:09

result of feeling

00:17:14:09 - 00:17:17:08

better about how you look.

00:17:17:08 - 00:17:19:02

Are there potential

00:17:19:02 - 00:17:19:22

that you guys have seen,

00:17:19:22 - 00:17:21:09

or is there any potential for this

00:17:21:09 - 00:17:23:00

to be like a mood booster

00:17:23:00 - 00:17:24:13

or stabilizer?

00:17:24:13 - 00:17:24:20

Right.

00:17:24:20 - 00:17:26:21

So I always tell my patients,

00:17:26:21 - 00:17:30:14

so if you lose 30 pounds right

00:17:30:16 - 00:17:31:17

before you your weight

00:17:31:17 - 00:17:33:08

loss, you are carrying a 30

00:17:33:08 - 00:17:35:20

pound bag walking every second.

00:17:35:20 - 00:17:37:05

Yeah yeah yeah. Fatigue.

00:17:37:05 - 00:17:38:04

You got frustrated.

00:17:38:04 - 00:17:38:14

Yes.

00:17:38:14 - 00:17:39:05

After the

00:17:39:05 - 00:17:39:23

the weight loss

00:17:39:23 - 00:17:41:23

you feel lighter and more energy.

00:17:41:23 - 00:17:42:23

Even though you may lose

00:17:42:23 - 00:17:44:07

some muscle mass

00:17:44:07 - 00:17:45:15

exercise can keep it that.

00:17:45:15 - 00:17:46:13

But do you feel better.

00:17:46:13 - 00:17:47:15

You know a lot of people

00:17:47:15 - 00:17:48:18

feel better.

00:17:48:18 - 00:17:49:16

Having said that,

00:17:49:16 - 00:17:51:05

there's some early studies

00:17:51:05 - 00:17:52:05

showing that,

00:17:52:05 - 00:17:54:01

some people may feel worse

00:17:54:01 - 00:17:55:14

psychologically.

00:17:55:14 - 00:17:56:18

Because you take away

00:17:56:18 - 00:17:58:11

the joy of the food.

00:17:58:11 - 00:17:59:17

Oh, some people are foodie.

00:17:59:17 - 00:18:01:04

You know, I love food, but I'd.

00:18:01:04 - 00:18:02:11

I'd rather

00:18:02:13 - 00:18:03:20

not fit in my clothes.

00:18:03:20 - 00:18:04:17

I don't I am good.

00:18:04:17 - 00:18:05:06

Exactly.

00:18:05:06 - 00:18:05:23

So, you know,

00:18:05:23 - 00:18:06:13

but overall

00:18:06:13 - 00:18:07:19

most people feel better.

00:18:07:19 - 00:18:09:23

Yeah. Okay, I love that.

00:18:09:23 - 00:18:10:17

There's obviously

00:18:10:17 - 00:18:11:19

the next question.

00:18:11:19 - 00:18:11:23

You know,

00:18:11:23 - 00:18:13:01

I remember when I would get it,

00:18:13:01 - 00:18:13:16

when I would go

00:18:13:16 - 00:18:14:19

get on this and discuss

00:18:14:19 - 00:18:15:13

with my friends and family.

00:18:15:13 - 00:18:16:00

Were like,

00:18:16:00 - 00:18:17:19

how long are you going

00:18:17:19 - 00:18:18:07

to take this?

00:18:18:07 - 00:18:18:22

Like, what's the

00:18:18:22 - 00:18:20:05

what's the plan for that?

00:18:20:05 - 00:18:21:15

So how long can people,

00:18:21:15 - 00:18:23:15

you know, stay on these GLP ones?

00:18:23:15 - 00:18:25:17

Yeah, that's, big unknown, right?

00:18:25:17 - 00:18:27:19

I did I unlocked something big.

00:18:27:19 - 00:18:28:18

Well,

00:18:28:18 - 00:18:29:17

I think this is a

00:18:29:17 - 00:18:30:22

point of contention. Right.

00:18:30:22 - 00:18:32:10

So how long are people

00:18:32:10 - 00:18:33:01

that we're going to see on

00:18:33:01 - 00:18:33:13

this for?

00:18:33:13 - 00:18:35:18

Like, if it's just for weight loss,

00:18:35:18 - 00:18:37:05

like for whether it's like health

00:18:37:05 - 00:18:39:11

or cosmetic reasons, then,

00:18:39:11 - 00:18:40:11

sure, you can take it

00:18:40:11 - 00:18:41:11

as long as you want to.

00:18:41:11 - 00:18:43:13

And it's been shown to be,

00:18:43:13 - 00:18:45:13

safe, you know, in terms of the,

00:18:45:13 - 00:18:47:03

long term data that is available.

00:18:47:03 - 00:18:48:03

But as soon as

00:18:48:03 - 00:18:49:08

someone stops the medicine,

00:18:49:08 - 00:18:51:07

then they put the weight back on.

00:18:51:07 - 00:18:51:17

Right.

00:18:51:17 - 00:18:53:12

So then this is sort of

00:18:53:12 - 00:18:55:09

like the catch 22 in terms of

00:18:55:09 - 00:18:56:09

how long are you really going

00:18:56:09 - 00:18:57:12

to be on it for.

00:18:57:12 - 00:18:58:04

And then once now

00:18:58:04 - 00:18:58:19

we're expanding

00:18:58:19 - 00:18:59:20

these indications right.

00:18:59:20 - 00:19:00:15

For sleep apnea,

00:19:00:15 - 00:19:02:20

for cardiovascular prevention,

00:19:02:20 - 00:19:04:18

for Alzheimer's prevention.

00:19:04:18 - 00:19:05:21

I mean yeah.

00:19:05:21 - 00:19:07:05

Like is this really going

00:19:07:05 - 00:19:08:12

to become a lifelong drug?

00:19:08:12 - 00:19:10:23

I, I think it's reasonable to,

00:19:10:23 - 00:19:12:06

think about that.

00:19:12:06 - 00:19:13:13

I do think the indication

00:19:13:13 - 00:19:15:12

is going to kind of,

00:19:15:12 - 00:19:17:03

modify that decision

00:19:17:03 - 00:19:18:20

and on the personal level as well.

00:19:18:20 - 00:19:19:14

Yeah, right.

00:19:19:14 - 00:19:21:11

If this is entirely a

00:19:21:11 - 00:19:22:12

like if someone's having

00:19:22:12 - 00:19:25:22

like overweight obesity as a

00:19:26:00 - 00:19:27:00

consequence of

00:19:27:00 - 00:19:27:10

like, you

00:19:27:10 - 00:19:28:05

know, bad habits,

00:19:28:05 - 00:19:29:21

whether it's like dietary choices

00:19:29:21 - 00:19:31:15

or not enough exercise then

00:19:31:15 - 00:19:32:07

you know, habits,

00:19:32:07 - 00:19:33:08

I always tell my patients

00:19:33:08 - 00:19:35:11

habits take years to develop,

00:19:35:11 - 00:19:35:16

right?

00:19:35:16 - 00:19:36:12

Like,

00:19:36:12 - 00:19:36:18

you know,

00:19:36:18 - 00:19:38:02

someone might have been

00:19:38:02 - 00:19:39:03

conditioning themselves

00:19:39:03 - 00:19:40:14

with this kind of, you know, say,

00:19:40:14 - 00:19:42:00

poor dietary choices for decades.

00:19:42:00 - 00:19:42:18

And then we're

00:19:42:18 - 00:19:43:07

all of a sudden

00:19:43:07 - 00:19:44:05

asking them, you know,

00:19:44:05 - 00:19:46:07

to change their diet and clinic

00:19:46:07 - 00:19:47:12

and it doesn't happen.

00:19:47:12 - 00:19:48:15

But now we have this

00:19:48:15 - 00:19:49:05

medication

00:19:49:05 - 00:19:50:09

that at least can kind

00:19:50:09 - 00:19:52:07

of take off that,

00:19:52:07 - 00:19:53:19

at that subconscious level

00:19:53:19 - 00:19:55:08

is affect their dietary choices.

00:19:55:08 - 00:19:55:14

Right?

00:19:55:14 - 00:19:56:22

And then they see the benefits.

00:19:56:22 - 00:19:58:05

They might be more motivated

00:19:58:05 - 00:19:59:20

to form better habits.

00:19:59:20 - 00:20:02:12

I think that is something that,

00:20:02:12 - 00:20:04:00

could be worked on in the future.

00:20:04:00 - 00:20:04:07

Right?

00:20:04:07 - 00:20:05:23

Like we shouldn't just say, hey,

00:20:05:23 - 00:20:06:23

this is the miracle medicine.

00:20:06:23 - 00:20:07:22

You got to keep taking it.

00:20:07:22 - 00:20:09:07

But there is going to be

00:20:09:07 - 00:20:11:06

that component of dietary lifestyle

00:20:11:06 - 00:20:12:04

counseling as well,

00:20:12:04 - 00:20:13:08

which is equally important.

00:20:13:08 - 00:20:14:20

And then, as you know,

00:20:14:20 - 00:20:15:12

now that we have

00:20:15:12 - 00:20:16:19

an effective treatment

00:20:16:19 - 00:20:18:02

that is going to be in greater

00:20:18:02 - 00:20:18:20

emphasis, right?

00:20:18:20 - 00:20:19:16

People are going to be coming

00:20:19:16 - 00:20:20:08

and seeing us more

00:20:20:08 - 00:20:22:06

to talk about this stuff.

00:20:22:06 - 00:20:24:12

So, that's kind of how I view it.

00:20:24:12 - 00:20:24:22

You know, it

00:20:24:22 - 00:20:25:14

certainly depends

00:20:25:14 - 00:20:27:12

on the indication,

00:20:27:14 - 00:20:28:09

depend on the patient's

00:20:28:09 - 00:20:30:17

motivations as well.

00:20:30:17 - 00:20:32:01

It's safe long term.

00:20:32:01 - 00:20:32:17

And then,

00:20:32:17 - 00:20:32:23

you know,

00:20:32:23 - 00:20:33:22

we'll see what the future holds,

00:20:33:22 - 00:20:35:07

what happens

00:20:35:07 - 00:20:38:14

when patients stop taking it?

00:20:38:16 - 00:20:40:21

Well, they put the weight back on.

00:20:40:21 - 00:20:41:02

Yep.

00:20:41:02 - 00:20:42:13

They if they you know,

00:20:42:13 - 00:20:43:22

if this medicine really does

00:20:43:22 - 00:20:45:15

kind of cut cravings for alcohol,

00:20:45:15 - 00:20:48:12

maybe they will,

00:20:48:12 - 00:20:49:04

start,

00:20:49:04 - 00:20:49:16

you know, feeling

00:20:49:16 - 00:20:52:03

this cravings again. Right.

00:20:52:03 - 00:20:53:21

In terms of preventing diabetes

00:20:53:21 - 00:20:55:00

or controlling diabetes,

00:20:55:00 - 00:20:56:00

if that's the indication

00:20:56:00 - 00:20:56:23

in the diabetes control

00:20:56:23 - 00:20:59:07

may get worse, right?

00:20:59:07 - 00:21:00:14

For heart failure

00:21:00:14 - 00:21:01:11

with preserved ejection

00:21:01:11 - 00:21:02:03

fraction, like,

00:21:02:03 - 00:21:03:05

there may be

00:21:03:05 - 00:21:04:06

lots of different components

00:21:04:06 - 00:21:04:19

at play there,

00:21:04:19 - 00:21:05:22

whether it's preserving, say,

00:21:05:22 - 00:21:07:14

kidney health or preserving,

00:21:07:14 - 00:21:09:16

just like their,

00:21:09:16 - 00:21:12:10

cardio metabolic syndrome, like,

00:21:12:10 - 00:21:13:21

we don't want that to go. Yeah.

00:21:13:21 - 00:21:15:02

Right. Yeah.

00:21:15:02 - 00:21:17:19

And there are improvements,

00:21:17:19 - 00:21:18:19

in their

00:21:18:19 - 00:21:20:04

cardiovascular risk

00:21:20:04 - 00:21:22:17

factors will be reversed.

00:21:22:17 - 00:21:23:13

So, you know,

00:21:23:13 - 00:21:25:08

their cholesterol is going to go up

00:21:25:08 - 00:21:27:06

their triglycerides.

00:21:27:06 - 00:21:29:13

Their blood pressure.

00:21:29:13 - 00:21:31:00

So, you know, patients

00:21:31:00 - 00:21:32:14

really need to understand

00:21:32:14 - 00:21:33:21

that these drugs

00:21:33:21 - 00:21:34:15

could

00:21:34:15 - 00:21:36:02

potentially be a long

00:21:36:02 - 00:21:37:18

term commitment,

00:21:37:18 - 00:21:38:11

particularly

00:21:38:11 - 00:21:39:17

if they're not modifying

00:21:39:17 - 00:21:40:16

their lifestyle.

00:21:40:16 - 00:21:42:20

I completely agree with Doctor

00:21:42:20 - 00:21:44:23

Lee that you know, one,

00:21:44:23 - 00:21:47:00

one one thing about these,

00:21:47:00 - 00:21:48:09

you know, therapies, right?

00:21:48:09 - 00:21:50:09

They are always considered

00:21:50:09 - 00:21:51:05

an adjunct

00:21:51:05 - 00:21:53:20

to a healthy lifestyle,

00:21:53:20 - 00:21:55:06

diet and exercise.

00:21:55:06 - 00:21:56:23

So it's crucial

00:21:56:23 - 00:21:59:00

that following a heart

00:21:59:00 - 00:22:01:00

healthy lifestyle,

00:22:01:00 - 00:22:02:07

you know,

00:22:02:07 - 00:22:02:14

you know,

00:22:02:14 - 00:22:04:08

such as a mediterranean

00:22:04:08 - 00:22:06:01

or dash type diet

00:22:06:01 - 00:22:08:00

with regular physical activity

00:22:08:00 - 00:22:10:08

that's still the foundation.

00:22:10:08 - 00:22:11:23

And patients

00:22:11:23 - 00:22:13:07

need to understand that.

00:22:13:07 - 00:22:15:23

And our health care systems need to

00:22:15:23 - 00:22:19:09

support that by making available,

00:22:19:11 - 00:22:21:19

registered dietitian nutritionist

00:22:21:19 - 00:22:24:19

that can help patients with

00:22:25:00 - 00:22:26:11

with their journey and,

00:22:26:11 - 00:22:30:02

and using these therapies together

00:22:30:04 - 00:22:31:22

with a heart healthy lifestyle

00:22:31:22 - 00:22:35:06

so that cannot be overemphasized.

00:22:35:07 - 00:22:37:00

Just another personal level.

00:22:37:00 - 00:22:38:02

What I thought.

00:22:38:02 - 00:22:39:11

So I took a break from them

00:22:39:11 - 00:22:40:22

and I,

00:22:40:22 - 00:22:41:07

I was

00:22:41:07 - 00:22:43:07

I made the mistake of thinking,

00:22:43:07 - 00:22:43:14

okay,

00:22:43:14 - 00:22:45:04

so I've modified my lifestyle,

00:22:45:04 - 00:22:46:18

I've changed my food consumption.

00:22:46:18 - 00:22:48:16

I, I've,

00:22:48:16 - 00:22:50:18

I'm kind of where I want to be.

00:22:50:18 - 00:22:52:11

Let me

00:22:52:13 - 00:22:53:22

back down, get off of them.

00:22:53:22 - 00:22:55:09

And hopefully these new habits

00:22:55:09 - 00:22:56:10

have stuck in these new

00:22:56:10 - 00:22:57:09

these new behaviors

00:22:57:09 - 00:22:58:08

are just going to be

00:22:58:08 - 00:22:59:11

part of my new normal and

00:22:59:11 - 00:23:01:05

and take hold.

00:23:01:05 - 00:23:03:08

That lasted all of a week.

00:23:03:08 - 00:23:04:21

And then I'm like, oh my God, here,

00:23:04:21 - 00:23:05:18

I'm craving food again.

00:23:05:18 - 00:23:06:12

I mean, it, it

00:23:06:12 - 00:23:09:07

it actually it shows you

00:23:09:07 - 00:23:12:01

the efficacy of these because

00:23:12:01 - 00:23:13:10

you can see it and feel it

00:23:13:10 - 00:23:13:19

in real time.

00:23:13:19 - 00:23:14:09

You're like, crap,

00:23:14:09 - 00:23:15:18

these cravings are back.

00:23:15:18 - 00:23:16:19

It happened

00:23:16:19 - 00:23:18:14

and I saw it and I felt it.

00:23:18:14 - 00:23:19:15

So it really I think to

00:23:19:15 - 00:23:20:18

all of your points about,

00:23:20:18 - 00:23:22:00

you know, it's almost like that

00:23:22:00 - 00:23:23:19

reverting back to where you were

00:23:23:19 - 00:23:24:10

when you started.

00:23:24:10 - 00:23:27:05

It's a real thing.

00:23:27:05 - 00:23:29:15

Let's talk about,

00:23:29:15 - 00:23:31:03

you know, the,

00:23:31:03 - 00:23:32:17

the coverage and the cost of these.

00:23:32:17 - 00:23:33:06

I know that

00:23:33:06 - 00:23:34:12

that some plans

00:23:34:12 - 00:23:35:11

will only cover them

00:23:35:11 - 00:23:36:10

for certain conditions.

00:23:36:10 - 00:23:37:12

And even then,

00:23:37:12 - 00:23:38:11

you know,

00:23:38:11 - 00:23:39:16

co-pays can range from somewhere

00:23:39:16 - 00:23:41:09

like 500 to $1000.

00:23:41:09 - 00:23:44:04

Why are they so expensive?

00:23:44:06 - 00:23:44:12

Right.

00:23:44:12 - 00:23:46:12

So,

00:23:46:12 - 00:23:47:15

as I mentioned, GLP-1

00:23:47:15 - 00:23:48:06

is a hormone.

00:23:48:06 - 00:23:51:23

Actually, was discovered in 1980s.

00:23:52:01 - 00:23:54:05

It took a long time to develop

00:23:54:05 - 00:23:55:18

GLP-1 drugs.

00:23:55:18 - 00:23:56:23

The first one was approved

00:23:56:23 - 00:23:59:07

I think in 2000 or in the 2000s

00:23:59:07 - 00:24:01:08

when very effective Ozempic

00:24:01:08 - 00:24:03:07

it was 2017.

00:24:03:07 - 00:24:05:10

So during that three decades,

00:24:05:10 - 00:24:06:18

there are a lot of patents,

00:24:06:18 - 00:24:07:19

a lot of research,

00:24:07:19 - 00:24:09:10

a lot of money invested.

00:24:09:10 - 00:24:10:17

So that's one reason

00:24:10:17 - 00:24:12:08

all new drugs are expensive

00:24:12:08 - 00:24:14:08

You know, these, typical

00:24:14:08 - 00:24:15:08

GLP-1 drugs

00:24:15:08 - 00:24:18:19

are quite expensive.

00:24:18:21 - 00:24:21:06

But, you know, I'm hopeful

00:24:21:06 - 00:24:22:12

that a lot of drug companies.

00:24:22:12 - 00:24:25:08

Right now, are developing

00:24:25:08 - 00:24:27:00

the kind of called next generation

00:24:27:00 - 00:24:29:04

GLP-1s

00:24:29:04 - 00:24:31:20

longer time, more effective.

00:24:31:20 - 00:24:33:07

I'm hopeful in the future.

00:24:33:07 - 00:24:34:04

Near future.

00:24:34:04 - 00:24:36:18

These new drug, newer drugs,

00:24:36:18 - 00:24:38:04

coming up, coming out.

00:24:38:04 - 00:24:39:08

And the older drugs

00:24:39:08 - 00:24:40:18

will be a bit cheaper.

00:24:40:18 - 00:24:42:02

Right now, they're quite expensive.

00:24:42:02 - 00:24:43:17

Of course, you know,

00:24:43:17 - 00:24:44:22

big pharma makes money

00:24:44:22 - 00:24:46:08

from these applications too.

00:24:46:08 - 00:24:46:20

So yeah, because,

00:24:46:20 - 00:24:47:04

you know,

00:24:47:04 - 00:24:48:17

data is the biggest

00:24:48:17 - 00:24:50:00

pharmaceutical company right now

00:24:50:00 - 00:24:50:21

because of these drugs.

00:24:50:21 - 00:24:51:04

Is it

00:24:51:04 - 00:24:52:04

one of those things

00:24:52:04 - 00:24:54:02

where the popularity is there,

00:24:54:02 - 00:24:54:23

the demand is there.

00:24:54:23 - 00:24:56:22

So you can you can charge more.

00:24:56:22 - 00:24:58:11

Is that it? Kind of.

00:24:58:11 - 00:25:00:17

Well, just the volume.

00:25:00:17 - 00:25:01:13

Yes, the volume and

00:25:01:13 - 00:25:02:22

and people are using it. Okay.

00:25:02:22 - 00:25:04:18

And you know, some drugs,

00:25:04:18 - 00:25:05:19

very few people use it.

00:25:05:19 - 00:25:06:16

But these drugs,

00:25:06:16 - 00:25:08:04

you know, just so popular

00:25:08:04 - 00:25:09:03

right now.

00:25:09:03 - 00:25:10:22

And I know that people are turning

00:25:10:22 - 00:25:12:16

to compounding at pharmacies

00:25:12:16 - 00:25:13:07

and things like that

00:25:13:07 - 00:25:14:10

to try to find it cheaper.

00:25:14:10 - 00:25:15:11

No, you're shaking your head.

00:25:15:11 - 00:25:17:18

No, not a not you don't know.

00:25:17:18 - 00:25:18:20

What do you tell your patients

00:25:18:20 - 00:25:19:11

like that.

00:25:19:11 - 00:25:21:23

You don't. Why idea why?

00:25:21:23 - 00:25:23:23

The problem is that

00:25:23:23 - 00:25:27:12

these are not regulated by the FDA,

00:25:27:14 - 00:25:30:08

so we don't quite know what.

00:25:30:08 - 00:25:32:18

So the patient doesn't quite know

00:25:32:18 - 00:25:34:23

what they're getting right there.

00:25:34:23 - 00:25:37:20

Compounded with other therapies.

00:25:37:20 - 00:25:40:19

And and there have been reports of,

00:25:40:19 - 00:25:43:09

adverse effects on,

00:25:43:09 - 00:25:44:12

some of these,

00:25:44:12 - 00:25:45:23

compounded therapies.

00:25:45:23 - 00:25:48:23

So we always, recommend

00:25:48:23 - 00:25:52:14

sticking with the FDA approved,

00:25:52:16 - 00:25:54:14

branded therapies.

00:25:54:14 - 00:25:54:22

Got it.

00:25:54:22 - 00:25:58:00

Why aren't they regulated?

00:25:58:00 - 00:25:59:03

And pardon my ignorance on that.

00:25:59:03 - 00:26:00:16

But what is where

00:26:00:16 - 00:26:02:10

the lack of regulation on this.

00:26:02:10 - 00:26:03:19

So those are compound

00:26:03:19 - 00:26:06:05

medications are made by pharmacies.

00:26:06:05 - 00:26:07:17

Those pharmacies are not

00:26:07:17 - 00:26:08:21

a federal government

00:26:08:21 - 00:26:09:22

regulated okay.

00:26:09:22 - 00:26:11:07

Those are mostly state

00:26:11:07 - 00:26:12:20

regulated controlled.

00:26:12:20 - 00:26:15:17

And there are no specific,

00:26:15:17 - 00:26:17:00

kind of laws

00:26:17:00 - 00:26:19:19

governing that regulation, either.

00:26:19:19 - 00:26:21:12

So not only GLP-1

00:26:21:12 - 00:26:21:23

there are

00:26:21:23 - 00:26:22:13

many are

00:26:22:13 - 00:26:24:06

the type of medications

00:26:24:06 - 00:26:26:04

are compounding medications,

00:26:26:04 - 00:26:27:20

as I agree with Doctor Wong

00:26:27:20 - 00:26:29:15

try to avoid that.

00:26:29:15 - 00:26:30:15

But having said that,

00:26:30:15 - 00:26:31:23

there are some nuance

00:26:31:23 - 00:26:35:05

here about the cost. Because,

00:26:35:07 - 00:26:36:23

it's not covered.

00:26:36:23 - 00:26:39:01

So I think, I'm really hopeful.

00:26:39:01 - 00:26:40:07

As I mentioned,

00:26:40:07 - 00:26:41:15

in the near future,

00:26:41:15 - 00:26:43:02

these medications would be cheaper

00:26:43:02 - 00:26:44:14

and more affordable. Good.

00:26:44:14 - 00:26:46:11

I hope so, too. Yeah.

00:26:46:11 - 00:26:47:11

Back at the start of the year

00:26:47:11 - 00:26:47:22

in January,

00:26:47:22 - 00:26:48:12

I know Medicare

00:26:48:12 - 00:26:49:14

and Medicaid stopped

00:26:49:14 - 00:26:51:14

covering them for weight loss.

00:26:51:14 - 00:26:52:20

Maybe you guys can tackle that.

00:26:52:20 - 00:26:53:08

How does that

00:26:53:08 - 00:26:54:14

then affect your patients

00:26:54:14 - 00:26:55:18

and what you're telling them

00:26:55:18 - 00:26:57:09

or what they're able to to do?

00:26:57:09 - 00:27:00:13

I think Medicare,

00:27:00:15 - 00:27:02:07

didn't cover the weight

00:27:02:07 - 00:27:04:12

loss component. Got it.

00:27:04:12 - 00:27:07:20

Medicaid California Medi-Cal did.

00:27:07:20 - 00:27:08:11

Got it.

00:27:08:11 - 00:27:09:23

But from January,

00:27:09:23 - 00:27:10:16

that part,

00:27:10:16 - 00:27:13:15

it will be removed, meaning,

00:27:13:15 - 00:27:14:10

the insurance,

00:27:14:10 - 00:27:18:09

Medicare and Medicaid will cover

00:27:18:11 - 00:27:20:12

obesity with comorbidities,

00:27:20:12 - 00:27:21:13

meaning diabetes

00:27:21:13 - 00:27:22:06

or cardiovascular

00:27:22:06 - 00:27:23:20

disease type of things.

00:27:23:20 - 00:27:25:13

So that would affect,

00:27:25:13 - 00:27:26:14

a lot of people

00:27:26:14 - 00:27:28:03

while on or plan

00:27:28:03 - 00:27:29:22

to be on the treatment.

00:27:29:22 - 00:27:32:03

So, you know, it's

00:27:32:03 - 00:27:33:06

challenging to manage

00:27:33:06 - 00:27:34:22

those patients. Yeah.

00:27:34:22 - 00:27:38:17

And we're concerned that, you know,

00:27:38:19 - 00:27:41:09

this these therapies not

00:27:41:09 - 00:27:42:16

being

00:27:42:16 - 00:27:43:14

as available

00:27:43:14 - 00:27:45:20

to our Medicaid patients,

00:27:45:20 - 00:27:47:02

this is going to result

00:27:47:02 - 00:27:50:03

in increased health disparities

00:27:50:03 - 00:27:53:03

with respect to obesity and

00:27:53:05 - 00:27:54:14

the other benefits

00:27:54:14 - 00:27:56:11

that these therapies have.

00:27:56:11 - 00:28:00:11

So it's a major concern among our,

00:28:00:13 - 00:28:02:08

underserved populations

00:28:02:08 - 00:28:05:08

that have an excess of of

00:28:05:09 - 00:28:07:04

of obesity, diabetes

00:28:07:04 - 00:28:09:03

and cardiovascular disease.

00:28:09:03 - 00:28:10:09

Is there a point, though,

00:28:10:09 - 00:28:12:21

where you will be able to prove

00:28:12:21 - 00:28:13:16

that these folks

00:28:13:16 - 00:28:15:07

do need this, right,

00:28:15:07 - 00:28:17:12

and so that they are covered?

00:28:17:12 - 00:28:18:08

I mean, I

00:28:18:08 - 00:28:19:07

maybe I'm not under

00:28:19:07 - 00:28:20:15

maybe I don't have a full,

00:28:20:15 - 00:28:20:23

you know,

00:28:20:23 - 00:28:22:01

scope of understanding on it.

00:28:22:01 - 00:28:23:00

But if someone

00:28:23:00 - 00:28:24:03

actually requires this

00:28:24:03 - 00:28:25:08

in terms of public health,

00:28:25:08 - 00:28:26:04

right, the,

00:28:26:04 - 00:28:27:11

the general larger public,

00:28:27:11 - 00:28:28:12

if you can point to this

00:28:28:12 - 00:28:30:21

and say these folks need this,

00:28:30:21 - 00:28:31:16

this is improving

00:28:31:16 - 00:28:32:20

their quality of life, it's

00:28:32:20 - 00:28:34:23

improving public health.

00:28:34:23 - 00:28:36:06

How can they say, no?

00:28:36:06 - 00:28:37:05

It's a very good question.

00:28:37:05 - 00:28:38:05

So again,

00:28:38:05 - 00:28:39:04

insurance companies

00:28:39:04 - 00:28:39:17

that they have their

00:28:39:17 - 00:28:41:02

clinical policies.

00:28:41:02 - 00:28:41:21

You're the expert.

00:28:41:21 - 00:28:42:05

You're saying,

00:28:42:05 - 00:28:43:06

hey, this person needs an

00:28:43:06 - 00:28:43:19

answer to that.

00:28:43:19 - 00:28:45:12

So so usually what do we do

00:28:45:12 - 00:28:47:02

is we go through with

00:28:47:02 - 00:28:49:19

call a PA Process, pre-authorization

00:28:49:19 - 00:28:51:06

to justify

00:28:51:06 - 00:28:52:07

why the patients

00:28:52:07 - 00:28:53:18

need the treatment.

00:28:53:18 - 00:28:55:08

For example, just simple example.

00:28:55:08 - 00:28:57:14

Sleep apnea is approved by FDA,

00:28:57:14 - 00:28:59:01

but not a lot of insurance

00:28:59:01 - 00:28:59:11

companies

00:28:59:11 - 00:29:01:23

don't approve that indication.

00:29:01:23 - 00:29:05:05

So so it just, there's a reason,

00:29:05:07 - 00:29:06:05

a lot of patients

00:29:06:05 - 00:29:07:03

are not benefiting.

00:29:07:03 - 00:29:07:17

Those are

00:29:07:17 - 00:29:09:23

these revolutionary drugs.

00:29:09:23 - 00:29:12:05

It's very unfortunate. Yeah, yeah.

00:29:12:05 - 00:29:14:21

Doctor Wong, what studies

00:29:14:21 - 00:29:16:15

do you guys have going on right now

00:29:16:15 - 00:29:17:15

that that are new, that

00:29:17:15 - 00:29:19:03

maybe we haven't touched on? Yeah.

00:29:19:03 - 00:29:20:12

So this continues

00:29:20:12 - 00:29:21:15

to be an active

00:29:21:15 - 00:29:24:06

area of our work at, UC Irvine.

00:29:24:06 - 00:29:27:06

So, one study

00:29:27:07 - 00:29:29:16

is we're looking at a,

00:29:29:18 - 00:29:32:08

national,

00:29:32:08 - 00:29:35:00

national electronic Health

00:29:35:00 - 00:29:38:00

record database and trying to

00:29:38:03 - 00:29:41:07

understand what are the,

00:29:41:09 - 00:29:43:05

social determinants of health

00:29:43:05 - 00:29:44:09

as well as quality

00:29:44:09 - 00:29:48:01

of life issues that may affect

00:29:48:03 - 00:29:50:18

patients long term adherence

00:29:50:18 - 00:29:52:06

and their success

00:29:52:06 - 00:29:54:15

on these therapies, particularly

00:29:54:15 - 00:29:59:09

with respect to diabetes control.

00:29:59:11 - 00:30:00:04

But, you know,

00:30:00:04 - 00:30:00:20

we're also going

00:30:00:20 - 00:30:04:03

to look to see how,

00:30:04:05 - 00:30:05:20

you know, their success

00:30:05:20 - 00:30:07:18

with controlling obesity

00:30:07:18 - 00:30:09:16

might be affected by these factors.

00:30:09:16 - 00:30:11:23

So that's one ongoing study.

00:30:11:23 - 00:30:15:03

We're also planning to,

00:30:15:05 - 00:30:16:17

getting back to the

00:30:16:17 - 00:30:18:03

prediabetes issue,

00:30:18:03 - 00:30:21:19

because I think this is one of the,

00:30:21:21 - 00:30:23:06

underappreciated

00:30:23:06 - 00:30:26:12

benefits of these therapies.

00:30:26:12 - 00:30:28:16

Is their potential effect

00:30:28:16 - 00:30:32:13

on reducing diabetes incidence,

00:30:32:15 - 00:30:33:16

which, as I said,

00:30:33:16 - 00:30:34:23

was already shown

00:30:34:23 - 00:30:36:18

by the select trial

00:30:36:18 - 00:30:38:21

more than a 70% reduction.

00:30:38:21 - 00:30:40:09

So we're

00:30:40:09 - 00:30:42:11

we're trying to investigate,

00:30:42:11 - 00:30:44:04

because of course, you know, that

00:30:44:04 - 00:30:47:08

that clinical trials are oftentimes

00:30:47:08 - 00:30:49:07

done in very

00:30:49:09 - 00:30:50:10

select highly

00:30:50:10 - 00:30:52:02

motivated populations.

00:30:52:02 - 00:30:55:02

But what might the effects be in

00:30:55:04 - 00:30:56:20

real-world population?

00:30:56:20 - 00:30:59:13

So we're planning a study

00:30:59:13 - 00:31:02:03

that's going to look at that.

00:31:02:05 - 00:31:05:02

And, we also continue

00:31:05:02 - 00:31:08:22

to be interested in, looking at,

00:31:09:00 - 00:31:12:16

how does use and maybe

00:31:12:16 - 00:31:13:19

also the

00:31:13:19 - 00:31:15:15

benefits of these therapies,

00:31:15:15 - 00:31:17:08

how might it differ

00:31:17:08 - 00:31:19:01

across different

00:31:19:01 - 00:31:20:20

race and ethnic groups?

00:31:20:20 - 00:31:24:09

There's important

00:31:24:11 - 00:31:28:14

Hispanic Diabetes Initiative that,

00:31:28:16 - 00:31:31:02

Doctor Yang and others and myself

00:31:31:02 - 00:31:32:13

are involved with.

00:31:32:13 - 00:31:35:03

With which here at UC Irvine,

00:31:35:03 - 00:31:38:17

which is very interesting to see,

00:31:38:19 - 00:31:40:20

you know, how we can

00:31:40:20 - 00:31:44:00

better improve care among

00:31:44:02 - 00:31:47:00

the Hispanic population, which is,

00:31:47:00 - 00:31:49:13

you know, a very major part

00:31:49:13 - 00:31:53:02

of the Orange County population.

00:31:53:03 - 00:31:55:20

And so how how can we improve

00:31:55:20 - 00:31:57:11

diabetes care?

00:31:57:11 - 00:31:59:21

Not just through

00:31:59:21 - 00:32:02:21

use of these newer therapies.

00:32:02:23 - 00:32:06:08

But what's very important also are

00:32:06:11 - 00:32:08:00

other factors

00:32:08:00 - 00:32:10:04

that affect outcomes in people

00:32:10:04 - 00:32:11:11

with diabetes, right?

00:32:11:11 - 00:32:12:18

Such as better

00:32:12:18 - 00:32:14:03

blood pressure control

00:32:14:03 - 00:32:16:20

and lipid control. So,

00:32:16:22 - 00:32:19:20

for a number of years, we've,

00:32:19:20 - 00:32:22:13

done work in this area

00:32:22:13 - 00:32:25:19

looking at how composite,

00:32:25:21 - 00:32:28:15

control of multiple factors

00:32:28:15 - 00:32:31:23

can really improve outcomes

00:32:31:23 - 00:32:32:23

in people

00:32:32:23 - 00:32:34:06

with diabetes, such

00:32:34:06 - 00:32:36:11

as we've shown that,

00:32:36:11 - 00:32:39:11

control of LDL cholesterol,

00:32:39:11 - 00:32:41:14

blood pressure and,

00:32:41:14 - 00:32:45:00

and, a1 c together can,

00:32:45:02 - 00:32:46:08

reduce,

00:32:46:08 - 00:32:49:19

cardiovascular events by about 60%.

00:32:49:19 - 00:32:51:09

So,

00:32:51:09 - 00:32:54:00

so, yeah, so this is,

00:32:54:00 - 00:32:54:20

you know,

00:32:54:20 - 00:32:58:18

a very active area of our, our work

00:32:58:18 - 00:33:02:15

and Doctor Yang, Doctor Lee and I

00:33:02:17 - 00:33:03:01

you know,

00:33:03:01 - 00:33:07:00

are also part of a new Center for

00:33:07:00 - 00:33:11:06

Global Cardiometabolic Health and Nutrition

00:33:11:06 - 00:33:15:23

which is doing collaborative research

00:33:15:23 - 00:33:19:01

across different schools

00:33:19:01 - 00:33:21:08

within the university, such as the

00:33:21:08 - 00:33:24:23

School of Pharmacy, Nursing,

00:33:24:23 - 00:33:27:21

and Information and Computer Sciences

00:33:27:21 - 00:33:29:09

as well as medicine

00:33:29:09 - 00:33:32:10

and public health and, you know,

00:33:32:14 - 00:33:37:07

trying to see how we can

00:33:37:09 - 00:33:38:23

improve outcomes,

00:33:38:23 - 00:33:40:15

particularly in our

00:33:40:15 - 00:33:41:23

underserved patients

00:33:41:23 - 00:33:43:19

with obesity and diabetes.

00:33:43:19 - 00:33:44:15

Yeah.

00:33:44:15 - 00:33:45:11

Well, I mean, listening

00:33:45:11 - 00:33:46:17

to you guys talk,

00:33:46:17 - 00:33:47:06

I mean, clearly

00:33:47:06 - 00:33:47:21

you're knowledgeable

00:33:47:21 - 00:33:48:14

and it's a it's a

00:33:48:14 - 00:33:49:05

it's a it's

00:33:49:05 - 00:33:50:09

it's got to be exciting for

00:33:50:09 - 00:33:51:09

you guys to be,

00:33:51:09 - 00:33:53:00

you know, exploring something.

00:33:53:00 - 00:33:53:15

And what's next

00:33:53:15 - 00:33:55:13

with this thing that is so

00:33:55:13 - 00:33:56:18

yeah I to say hot right now

00:33:56:18 - 00:33:57:09

because I mean it's

00:33:57:09 - 00:33:58:03

a it's a medication

00:33:58:03 - 00:33:59:01

but it's so

00:33:59:01 - 00:34:01:11

in the public psyche right now.

00:34:01:11 - 00:34:02:07

So that's it's

00:34:02:07 - 00:34:03:11

thrilling that you guys are kind of

00:34:03:11 - 00:34:04:19

like leading that charge,

00:34:04:19 - 00:34:06:06

specifically UCI Health.

00:34:06:06 - 00:34:07:14

Doctor Yang.

00:34:07:14 - 00:34:08:18

What

00:34:08:18 - 00:34:10:08

options or what treatment

00:34:10:08 - 00:34:11:15

you know, things can does

00:34:11:15 - 00:34:12:21

UCI Health offer

00:34:12:21 - 00:34:13:21

people with diabetes

00:34:13:21 - 00:34:14:14

are looking for weight loss

00:34:14:14 - 00:34:16:19

that maybe other providers can't?

00:34:16:19 - 00:34:17:03

Well.

00:34:17:03 - 00:34:17:16

And UCI

00:34:17:16 - 00:34:19:18

Health is the only academic

00:34:19:18 - 00:34:21:10

medical center in Orange County.

00:34:21:10 - 00:34:21:20

Yeah.

00:34:21:20 - 00:34:23:18

And we also have a diabetes center,

00:34:23:18 - 00:34:24:22

which is our own

00:34:24:22 - 00:34:27:12

research institute in the county.

00:34:27:12 - 00:34:28:23

So,

00:34:29:01 - 00:34:29:16

we use these

00:34:29:16 - 00:34:32:21

medications, but, we are also,

00:34:32:23 - 00:34:35:17

doing a couple of clinical trials,

00:34:35:17 - 00:34:39:00

testing the newer GLP-1 drugs

00:34:39:02 - 00:34:40:08

Some of them are oral.

00:34:40:08 - 00:34:40:14

You know,

00:34:40:14 - 00:34:41:05

you don't have to

00:34:41:05 - 00:34:42:15

go through injections.

00:34:42:15 - 00:34:43:23

Are they as effective?

00:34:43:23 - 00:34:46:01

So based on the preliminary data,

00:34:46:01 - 00:34:48:11

you know, they're quite effective.

00:34:48:11 - 00:34:49:17

Maybe not as effective

00:34:49:17 - 00:34:51:17

as the strongest drug,

00:34:51:17 - 00:34:54:17

injections, but fairly effective.

00:34:54:19 - 00:34:55:21

So there are, you know,

00:34:55:21 - 00:34:57:16

we are uniquely positioned

00:34:57:16 - 00:34:59:16

in different areas.

00:34:59:16 - 00:35:00:20

Other providers can help

00:35:00:20 - 00:35:03:19

provide research, clinical trials.

00:35:03:19 - 00:35:04:19

And our,

00:35:04:19 - 00:35:07:01

faculty members are outstanding.

00:35:07:01 - 00:35:07:13

And,

00:35:07:13 - 00:35:09:08

we actually the endocrine division

00:35:09:08 - 00:35:09:17

is ranked

00:35:09:17 - 00:35:10:19

number 50

00:35:10:19 - 00:35:12:07

among the 4500

00:35:12:07 - 00:35:13:19

hospitals in the country.

00:35:13:19 - 00:35:15:13

Oh my God, 23. Yeah.

00:35:15:13 - 00:35:16:21

Take a bow. Wow.

00:35:16:21 - 00:35:17:12

That's awesome.

00:35:17:12 - 00:35:18:16

Thank you. That's great.

00:35:18:16 - 00:35:20:10

Anything else?

00:35:20:10 - 00:35:21:22

That you guys,

00:35:21:22 - 00:35:22:09

you know,

00:35:22:09 - 00:35:23:01

I feel passionate

00:35:23:01 - 00:35:23:16

about getting out there.

00:35:23:16 - 00:35:24:13

Any messaging that

00:35:24:13 - 00:35:25:20

that maybe we missed

00:35:25:20 - 00:35:26:12

that you want someone

00:35:26:12 - 00:35:27:21

to really know and take away

00:35:27:21 - 00:35:30:08

before they either start these or,

00:35:30:08 - 00:35:33:01

you know, continue or stop them.

00:35:33:01 - 00:35:34:01

I mean, anything else?

00:35:34:01 - 00:35:34:22

Do we cover it all?

00:35:34:22 - 00:35:37:00

I'll just add and,

00:35:37:00 - 00:35:39:23

this again, reemphasize that

00:35:39:23 - 00:35:43:00

patients need to understand that

00:35:43:00 - 00:35:46:00

these drugs do far more than

00:35:46:05 - 00:35:47:12

promote weight loss.

00:35:47:12 - 00:35:47:21

Right.

00:35:47:21 - 00:35:49:20

And in our overweight

00:35:49:20 - 00:35:51:09

and and

00:35:51:09 - 00:35:52:08

in our patients

00:35:52:08 - 00:35:55:03

who have overweight and obesity,

00:35:55:03 - 00:35:56:13

cardiovascular disease

00:35:56:13 - 00:35:57:18

is their leading

00:35:57:18 - 00:35:58:23

cause of death, right?

00:35:58:23 - 00:36:01:18

So this includes heart failure.

00:36:01:18 - 00:36:03:16

This includes,

00:36:03:18 - 00:36:06:00

heart attacks,

00:36:06:00 - 00:36:07:18

and, and, atherosclerotic

00:36:07:18 - 00:36:09:04

CVD in general,

00:36:09:04 - 00:36:11:22

which also includes stroke.

00:36:11:22 - 00:36:12:09

Right.

00:36:12:09 - 00:36:12:23

These

00:36:12:23 - 00:36:15:10

these are going to be their major

00:36:15:10 - 00:36:16:09

causes of death.

00:36:16:09 - 00:36:19:01

So it's very important that

00:36:19:01 - 00:36:20:07

they understand

00:36:20:07 - 00:36:22:06

the cardiovascular benefits.

00:36:22:06 - 00:36:23:21

And our cardiology

00:36:23:21 - 00:36:27:02

community really needs to,

00:36:27:04 - 00:36:29:16

to embrace these as,

00:36:29:16 - 00:36:32:10

as therapies that

00:36:32:10 - 00:36:34:22

are not just for weight loss

00:36:34:22 - 00:36:37:14

and not not only for diabetes,

00:36:37:14 - 00:36:38:11

which is of course,

00:36:38:11 - 00:36:39:08

very important,

00:36:39:08 - 00:36:42:11

but as cardiovascular therapies.

00:36:42:11 - 00:36:44:06

And I think certainly,

00:36:44:06 - 00:36:44:15

you know,

00:36:44:15 - 00:36:46:23

with all the emerging data

00:36:46:23 - 00:36:48:23

with heart failure

00:36:48:23 - 00:36:50:15

that Doctor Lee

00:36:50:15 - 00:36:53:05

talked about, you know, they

00:36:53:05 - 00:36:54:19

well, hopefully soon be.

00:36:54:19 - 00:36:56:19

But I think that's the

00:36:56:19 - 00:36:58:00

number one message

00:36:58:00 - 00:36:59:11

that I have for

00:36:59:11 - 00:37:00:23

patients that it's

00:37:00:23 - 00:37:03:02

they're much more than weight

00:37:03:02 - 00:37:04:18

loss, right. Yeah.

00:37:04:18 - 00:37:06:21

But and just to expand on that too,

00:37:06:21 - 00:37:07:08

you know, there's

00:37:07:08 - 00:37:10:04

this new concept in our field

00:37:10:04 - 00:37:13:21

called cardio kidney metabolic. So,

00:37:13:23 - 00:37:14:18

expanding not

00:37:14:18 - 00:37:16:14

just from the,

00:37:16:14 - 00:37:18:14

you know, cardiac side of things.

00:37:18:14 - 00:37:20:00

As, Doctor

00:37:20:00 - 00:37:20:18

Wong has been talking about,

00:37:20:18 - 00:37:21:21

but also, you know,

00:37:21:21 - 00:37:25:15

renal health, like, with diabetes,

00:37:25:17 - 00:37:27:20

comes attention to kidney function

00:37:27:20 - 00:37:29:01

and preventing the development

00:37:29:01 - 00:37:30:09

of diabetic kidney disease.

00:37:30:09 - 00:37:31:21

And these medicines

00:37:31:21 - 00:37:33:01

have demonstrated

00:37:33:01 - 00:37:34:20

some renal benefits as well

00:37:34:20 - 00:37:35:15

you know, so

00:37:35:15 - 00:37:38:12

cardio kidney, metabolic like,

00:37:38:12 - 00:37:40:19

these ailments like affect

00:37:40:19 - 00:37:42:15

a large size of our population.

00:37:42:15 - 00:37:42:22

Right.

00:37:42:22 - 00:37:45:08

So in terms of this program today,

00:37:45:08 - 00:37:46:14

just trying to attention

00:37:46:14 - 00:37:47:04

like these health

00:37:47:04 - 00:37:48:23

benefits that this

00:37:48:23 - 00:37:51:00

family of medications can offer.

00:37:51:00 - 00:37:52:01

It's huge.

00:37:52:01 - 00:37:53:11

And really

00:37:53:11 - 00:37:54:15

it's not just about weight

00:37:54:15 - 00:37:55:18

loss, but,

00:37:55:18 - 00:37:56:22

seeking out medical providers

00:37:56:22 - 00:37:57:13

just to talk about

00:37:57:13 - 00:37:58:15

if these type of medicines

00:37:58:15 - 00:38:00:05

are right for them. Yeah.

00:38:00:05 - 00:38:01:08

I think that's a huge advantage

00:38:01:08 - 00:38:02:21

in terms of,

00:38:02:21 - 00:38:03:12

talking about future

00:38:03:12 - 00:38:04:18

health as well. Right?

00:38:04:18 - 00:38:04:21

Yeah.

00:38:04:21 - 00:38:06:03

That reminds me of the strength

00:38:06:03 - 00:38:07:10

at UCI Health,

00:38:07:10 - 00:38:07:22

which is the

00:38:07:22 - 00:38:09:13

interdisciplinary approach

00:38:09:13 - 00:38:11:06

to manage these patients.

00:38:11:06 - 00:38:12:03

So, Doctor Lee,

00:38:12:03 - 00:38:13:12

I, endocrinology

00:38:13:12 - 00:38:15:08

you know, kidney doctors

00:38:15:08 - 00:38:15:23

and we all work

00:38:15:23 - 00:38:17:18

together, specifically, you know,

00:38:17:18 - 00:38:19:08

we are same medical record system.

00:38:19:08 - 00:38:20:21

We communicate all the time.

00:38:20:21 - 00:38:21:15

So that's the strength

00:38:21:15 - 00:38:22:13

of our system.

00:38:22:13 - 00:38:23:10

Fascinating stuff.

00:38:23:10 - 00:38:23:13

I know

00:38:23:13 - 00:38:24:12

we're talking about GLP-1s,

00:38:24:12 - 00:38:24:23

but I'm going to call

00:38:24:23 - 00:38:26:08

you guys the GLP-3.

00:38:26:08 - 00:38:28:04

This is this is nice.

00:38:28:04 - 00:38:29:04

Yeah. Thank you guys.

00:38:29:04 - 00:38:30:00

Thank you very much

00:38:30:00 - 00:38:31:10

for your time and your expertise.

00:38:31:10 - 00:38:32:11

And I know this is going

00:38:32:11 - 00:38:34:02

to be beneficial for a lot of folks

00:38:34:02 - 00:38:34:07

to hear

00:38:34:07 - 00:38:35:17

for a lot of different reasons too.

00:38:35:17 - 00:38:37:00

It's a really exciting thing

00:38:37:00 - 00:38:37:19

and I'm excited

00:38:37:19 - 00:38:38:16

that we had your time today.

00:38:38:16 - 00:38:39:17

So thank you guys.

00:38:39:17 - 00:38:40:11

Thank you.

00:38:40:11 - 00:38:41:07

Thank you for next time.

00:38:41:07 - 00:38:42:14

It's Live Well with UCI Health.