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Clinical · Comorbidities

Gallbladder disease risk with rapid weight loss

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Solved by a.delgado in post #9
Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone.

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IB
i.boatengTL2 Moderator10 Aug 2024#1

Posting this under the heading it deserves: Gallbladder disease risk with rapid weight loss Everything below is what sits behind that.

General question, not a request for advice about my own care — I know the difference and I would rather be told to see my prescriber than get an answer that pretends otherwise.

I have a panel in front of me with one value outside the reference interval and everything else within it. My instinct is that a single out-of-range result on a single draw is close to uninformative, and I would like to understand how the people who read these professionally think about that.

What I am actually asking is how to tell an interesting result from an uninteresting one before booking an appointment about it.

23 likes 2y
RI
retention_indexTL2Analytical chemist17 Aug 2024#2

Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.

26 likes 23mo
JV
j.vogelTL2 Moderator22 Aug 2024#3

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

0 likes 23mo
P
preregisteredTL3Research methods26 Aug 2024#4
j.vogel, post #3: I disagree with the reply above, and I think the disagreement is substantive rather than terminological. The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient. Go to post

Coming back to post #3, because the follow-up matters more than the original answer.

Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific medications and doses with a clinician familiar with bariatric surgery is prudent.

4 likes in reply to #3 23mo
YR
y.rahimiTL2 Moderator30 Aug 2024#5

post #4 is right about the mechanism and I think understates the practical bit.

Obstructive sleep apnoea: SURMOUNT-OSA used an objective endpoint, the apnoea-hypopnoea index. Reduction was substantial. Whether the benefit is weight loss or a direct drug effect is not resolved by the trial.

8 likes 23mo
AD
appeals_deskTL3Regular3 Sep 2024#6

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

19 likes 23mo
AK
a.kirchnerTL2 Moderator7 Sep 2024#7

Hepatic steatosis and MASH: a phase 2 trial in semaglutide for steatohepatitis showed resolution was more frequent on treatment. Histological resolution is a surrogate for long-term clinical outcomes like cirrhosis.

0 likes 23mo
LI
l.ibarraTL2Regular10 Sep 2024 · edited#8
appeals_desk, post #6: Two things before anyone answers the substance. First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound. Go to post

Chronic kidney disease: compounds in this class have renal benefit in people with kidney disease. The benefit appears to be additive to other renal-protective agents, not a replacement for them.

2 likes in reply to #6 23mo
AD
a.delgadoTL2 Moderator Solution14 Sep 2024#9

Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone.

25 likes 22mo
RF
resistance_firstTL2Regular17 Sep 2024#10

On post #6 — agreed on the reasoning, with one qualification.

Type 2 diabetes: the population with the largest evidence base for these compounds. The SURPASS and SUSTAIN programmes established glycaemic benefit. The renal and cardiovascular benefit evidence is separate from the glycaemic benefit evidence.

0 likes 22mo
IS
isotonic_sheetTL3Regular20 Sep 2024#11

Coming back to post #9, because the follow-up matters more than the original answer.

Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.

7 likes 22mo
PK
p.krastevTL2 Moderator23 Sep 2024#12

PCOS and metabolic overlap: polycystic ovary syndrome has metabolic overlap with obesity and insulin resistance. Data on compounds in this class in PCOS specifically is thin; most discussion is by mechanism.

1 like 22mo
RV
r.venkatesanTL3Wiki editor26 Sep 2024#13
resistance_first, post #10: On post #6 — agreed on the reasoning, with one qualification. Type 2 diabetes: the population with the largest evidence base for these compounds. The SURPASS and SUSTAIN programmes established glycaemic benefit. The renal and cardiovascular benefit evidence is separate from the glycaemic benefit evidence. Go to post

Type 2 diabetes: the population with the largest evidence base for these compounds. The SURPASS and SUSTAIN programmes established glycaemic benefit. The renal and cardiovascular benefit evidence is separate from the glycaemic benefit evidence.

0 likes in reply to #10 22mo
KP
k.pereiraTL2 Moderator29 Sep 2024#14
l.ibarra, post #8: Chronic kidney disease: compounds in this class have renal benefit in people with kidney disease. The benefit appears to be additive to other renal-protective agents, not a replacement for them. Go to post

post #13 answers the question as asked. The question underneath it is different.

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

23 likes in reply to #8 22mo
EA
e.almeidaTL2Member2 Oct 2024 · edited#15

I read post #13 twice before replying, because I had assumed the opposite.

Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.

3 likes 22mo
RS
r.sobczakTL2 Moderator5 Oct 2024#16

This follows post #13 rather than contradicting it.

Multiple comorbidities: a person with diabetes, kidney disease, and cardiovascular disease is outside the studied populations in most trials. Extrapolating to that person requires reasoning from the individual component trials and mechanisms.

0 likes 22mo
RJ
r.jhannsdttirTL3Regular8 Oct 2024#17

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

33 likes 22mo
NK
ni.kravchenkoTL2 Moderator11 Oct 2024#18
l.ibarra, post #8: Chronic kidney disease: compounds in this class have renal benefit in people with kidney disease. The benefit appears to be additive to other renal-protective agents, not a replacement for them. Go to post

PCOS and metabolic overlap: polycystic ovary syndrome has metabolic overlap with obesity and insulin resistance. Data on compounds in this class in PCOS specifically is thin; most discussion is by mechanism.

17 likes in reply to #8 22mo
LS
l.sarkissianTL2Member14 Oct 2024#19
i.boateng, post #1: Posting this under the heading it deserves: Gallbladder disease risk with rapid weight loss Everything below is what sits behind that. General question, not a request for advice about my own care — I know the difference and I would rather be told to see my prescriber than get an answer that pretends otherwise. I have a panel in front of… Go to post

Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.

1 like in reply to #1 21mo
TM
t.marchettiTL2 Moderator17 Oct 2024#20

Picking up post #17: that is the part I would want checked first.

Obstructive sleep apnoea: SURMOUNT-OSA used an objective endpoint, the apnoea-hypopnoea index. Reduction was substantial. Whether the benefit is weight loss or a direct drug effect is not resolved by the trial.

0 likes 21mo
SP
s.poulsenTL3Regular19 Oct 2024#21

Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone.

17 likes 21mo
MA
mi.almeidaTL2 Moderator22 Oct 2024 · edited#22

Hepatic steatosis and MASH: a phase 2 trial in semaglutide for steatohepatitis showed resolution was more frequent on treatment. Histological resolution is a surrogate for long-term clinical outcomes like cirrhosis.

33 likes 21mo
AR
ambient_reviewTL3Regular25 Oct 2024#23

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

1 like 21mo
AP
a.petrovTL2 Moderator28 Oct 2024#24
s.poulsen, post #21: Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone. Go to post

On post #20 — agreed on the reasoning, with one qualification.

Chronic kidney disease: compounds in this class have renal benefit in people with kidney disease. The benefit appears to be additive to other renal-protective agents, not a replacement for them.

7 likes in reply to #21 21mo
JH
j.habermannTL3Regular30 Oct 2024#25

This follows post #22 rather than contradicting it.

Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific medications and doses with a clinician familiar with bariatric surgery is prudent.

11 likes 21mo
DN
d.nwosuTL2 Moderator2 Nov 2024#26

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

25 likes 21mo
KF
k.farrugiaTL3Regular4 Nov 2024#27
e.almeida, post #15: I read post #13 twice before replying, because I had assumed the opposite. Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables. Go to post

Obstructive sleep apnoea: SURMOUNT-OSA used an objective endpoint, the apnoea-hypopnoea index. Reduction was substantial. Whether the benefit is weight loss or a direct drug effect is not resolved by the trial.

0 likes in reply to #15 21mo
KO
k.okaforTL2 Moderator7 Nov 2024#28
mi.almeida, post #22: Hepatic steatosis and MASH: a phase 2 trial in semaglutide for steatohepatitis showed resolution was more frequent on treatment. Histological resolution is a surrogate for long-term clinical outcomes like cirrhosis. Go to post

Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.

3 likes in reply to #22 21mo
SS
s.silvaTL2 Moderator10 Nov 2024 · edited#29
resistance_first, post #10: On post #6 — agreed on the reasoning, with one qualification. Type 2 diabetes: the population with the largest evidence base for these compounds. The SURPASS and SUSTAIN programmes established glycaemic benefit. The renal and cardiovascular benefit evidence is separate from the glycaemic benefit evidence. Go to post

Picking up post #26: that is the part I would want checked first.

Multiple comorbidities: a person with diabetes, kidney disease, and cardiovascular disease is outside the studied populations in most trials. Extrapolating to that person requires reasoning from the individual component trials and mechanisms.

32 likes in reply to #10 21mo
EF
e.ferrariTL212 Nov 2024#30