News | St. Thomas Medical Group
diabetes injection

Is There a Once a Week Injection that Controls My Diabetes and Helps with Weight Loss?

According to a 2017 report from the CDC, more than 100 million Americans live with diabetes or prediabetes. As we shared on the blog several months ago, nearly 15% of the adult population in Tennessee has diabetes, while 35.8% has prediabetes.

As diabetes becomes a growing concern, many patients are asking their doctor about new and alternative solutions, such as the once-a-week diabetes injection. In addition to helping control diabetes, these injections can also contribute to weight loss, making them a win-win for many patients.

Ozempic, Trulicity & More: GLP-1 Receptor Agonist Medications

Adults with diabetes may have new management options thanks to a class of medications known as GLP-1 receptor agonists. These drugs aid the body in releasing insulin as a response to elevated blood sugar. These drugs are not insulin medications. Rather, they limit the amount of sugar that can enter the bloodstream from the liver. GLP-1 receptor agonists also control the rate at which food leaves the stomach. GLP-1 receptor agonists may be used alone or may be prescribed in addition to insulin.

Overview of Popular Once-a-Week Diabetes Injection Drugs

Diabetes In Control has provided a helpful chart that covers basic information about a few of the most popular GLP-1 receptor agonist medications on the market. We’ve summarized some of this information below. Patients and providers can access the full chart here.

Dulaglutide (Trulicity)

  • Half Life: ~5 days
  • Average HbA1c Reduction: ~1.5%
  • Dosing Considerations: Start with 0.75 mg once per week, increasing to 1.5 mg per week if inadequate glycemic response.
  • Short-term weight loss*: ~5.5 lbs

Exenatide (Byetta)

  • Half Life: 24 hours
  • Average HbA1c Reduction: ~1%
  • Dosing Considerations: Start with 5 mcg twice per day. After one month, this may be increased to 10 mcg for better glycemic control.
  • Short-term weight loss*: ~4.4 lbs

Exenatide Extended-Release (Bydureon, Bydureon BCise)

  • Half Life: > 1 week
  • Average HbA1c Reduction: ~1.5% (Bydureon), ~1.4% (Bydureon BCise)
  • Dosing Considerations: 2mg once weekly at any time of day, regardless of food.
  • Short-term weight loss*: ~5.5 lbs with Bydureon, ~3.1 lbs with Bydureon BCise

Liraglutide (Victoza, Saxenda)

  • Half Life: 12-14 hours
  • Average HbA1c Reduction: ~1.5%
  • Dosing Considerations: Start with 0.6 mg a day for one week; increase to 1.2 mg per day. If glycemic control is not achieved, increase to 1.8 mg daily.
  • Short-term weight loss*: ~5.5 lbs

Lixisenatide (Adlyxin)

  • Half Life: ~3 hours
  • Average HbA1c Reduction: ~1%
  • Dosing Considerations: Start with 10 mcg per day for 14 days, then increase to 20 mcg per day. Administer within one hour prior to the first meal of the day.
  • Short-term weight loss*: ~4.4 lbs

Insulin degludec/liraglutide (Xultophy 100/3.6)

  • Half Life: ~25 hours
  • Average HbA1c Reduction: ~1% more than insulin degludec alone.
  • Dosing Considerations: Start with 16 units per day and titrate up or down every 3-4 days in two units range.
  • Short-term weight loss*: ~5.5 lbs

Insulin Glargine/Lixisenatide (Soliqua 100/33)

  • Half Life: ~3 hours
  • A1C: 0.5% more than insulin glargine alone
  • Dosing Considerations: See sheet for details.
  • Short-term weight loss*: ~3 lbs (when compared to insulin glargine)

Semaglutide (Ozempic)

  • Half Life: ~1 week
  • Average HbA1c Reduction: ~1.5%
  • Dosing Considerations: Start with 0.25 mg per week at any time of day regardless of food. Increase to 0.5 mg per week after four weeks. Max dose of 1.0 mg per week.
  • Short-term weight loss*: ~8.4 lbs with Ozempic 0.5, ~10.4 lbs with Ozempic 1.0

Are GLP-1 Receptors Right for Me?

Only a doctor can recommend and prescribe this type of weekly diabetes injection. If you’re curious about learning more, talk to your internal medicine doctor at St. Thomas Medical Group. We’re here to partner with you in better health.

* Based on results of FDA-approved clinical trials


Do You Know Your Risk for Osteoporosis?

Those bones you had a decade ago? They aren’t there anymore! In fact, your bone matter might have a shorter lifespan than the carpet in your living room! But don’t be alarmed… all this is completely normal. Through a process known as “remodeling,” the body constantly removes and rebuilds bone material in the body. After a period of approximately ten years, the bone tissue in your body has been completely replaced with new bone…

…unless you have osteoporosis.

What Is Osteoporosis?

In patients with osteoporosis, the remodeling process can’t keep up. Bone matter is absorbed by the body faster than new bone matter is produced. This means that bones lose mass over time, becoming weak, brittle and prone to fracturing.

Many people have osteoporosis, but few are aware that they have this disease until they experience a fracture. According to the Centers for Disease Control and Prevention:

  • Nearly one in four women age 65 or older have osteoporosis of the femur, neck, or lumbar spine.

Does Osteoporosis Cause Symptoms?

In the early stages, symptoms are rarely seen. That’s just one reason why getting screened in an osteoporosis risk assessment is so important. (More on that in a moment.) Once bones have become affected by osteoporosis, the following symptoms may be observed:

  • Gradual loss of height
  • Stooped posture
  • Back pain (may be caused by a collapsed vertebra or fracture)
  • Bone fracture that occurs with minimal stress

Keep in mind, not all individuals with osteoporosis will experience noticeable symptoms.

Osteoporosis Risk Factors

Knowing the osteoporosis risk factors may empower you to work with your doctor at St. Thomas Medical Group to stop this disease before it occurs. There are some risk factors you can’t control. Let’s look at those first:

  • Being female
  • Being over the age of 50
  • Having a family history of the disease
  • Menopause
  • Having experienced broken bones or loss in height
  • Being thin or having a small frame

The good news is, there are some risk factors you can control:

  • If overweight, lose weight.
  • Reduce alcohol use to one drink per day (women) or two drinks per day (men) max.
  • Eat sufficient fruits, vegetables, vitamin D, and calcium.
  • Exercise regularly.
  • Don’t over consume sodium, protein or caffeine.
  • If you smoke, talk with your doctor about developing a cessation plan now.

Who Is At the Greatest Risk for Osteoporosis?

Historically, women over the age of 50 have been viewed as the highest risk group for osteoporosis. However, a recent report published in June 2019 notes that osteopenia is on the rise among middle-aged women and men. (Osteopenia may be best understood as the “in-between” state of having healthy bones v. having bones at risk for fracture. It’s sometimes called “pre-osteoporosis.”)

A clinician involved with the report astutely noted that certain risk factors for poor bone health are indiscriminate, affecting patients across lines of age, race and sex. These risk factors include excessive alcohol use, tobacco use, lack of weight-bearing exercise, low exposure to sunlight and vitamin D, poor nutrition and prolonged use of steroids and certain other medications.

Osteoporosis Risk Assessment & DEXA Scans

If you’re concerned that you may be at an increased risk for this bone disease, talk to your doctor about having an osteoporosis risk assessment. During an assessment, your physician may ask about your lifestyle, as well as personal medical and family histories.

A DEXA scan may also be ordered at this time. DEXA, which stands for “dual energy x-ray absorptiometry,” is a completely painless and non-invasive procedure in which two different x-ray beams are used to scan the bones; the difference between these beams’ findings may inform your clinician about possible bone loss.

Help for preventing bone loss is possible… but it’s important that you take action early. Get help now!

See a Rheumatologist In Nashville or Gallatin, TN

Schedule an appointment with a St. Thomas Medical Group rheumatology doctor in Nashville or Gallatin, TN. Schedule online or by calling +1 (615) 964-5823.

hepatitis c

Yes, Hepatitis C Is Curable. Here’s How.

Hepatitis is an inflammatory liver disease often caused by a virus. While there are many types of hepatitis, the most common in the United States are hepatitis A virus, hepatitis B virus, and hepatitis C virus. While there are vaccinations for the A and B viruses, no such vaccine exists for hepatitis C.

The good news is that while hepatitis C cannot be entirely prevented through a vaccination, the infection is now curable! (More on that in a bit.) Let’s begin by taking a closer look at this illness…

What Is Hepatitis C?

Hepatitis C is a liver infection; severity can range from a mild illness to a serious, chronic illness. Of those who contract hepatitis C, more than three in four will develop a chronic hepatitis C infection. Some individuals (fewer than one in four) will clear hepatitis C from their body without any treatment; researchers do not fully understand why this happens.

Acute v. Chronic Hepatitis C

Acute hepatitis C is used to describe a new infection; it typically occurs within six months of exposure to the virus.

Chronic hepatitis C may last throughout a patient’s entire lifetime. This infection could result in scarring, cancer, or damage of the liver. In some cases, chronic hepatitis C may even result in death.

The Prevalence of Hepatitis C

2,967 cases of acute hepatitis C were reported to the Centers for Disease Control and Prevention in 2016. However, many people with hepatitis C do not experience symptoms; others experience symptoms, but do not know the cause of their illness. In reality, the CDC estimates there were as many as 41,200 cases of hepatitis C in 2016 – nearly 14x the number of cases actually reported.

A Cure for Hepatitis C

As stated, above there is now a cure for hepatitis C. Treatments have improved markedly over the last few years. Now, more than 90% of people with hepatitis C can be successfully treated with an 8-12 week round of oral therapy. A list of FDA-approved drugs (many of which have few or mild side effects) can be reviewed here. Talk to your doctor to learn more about these hepatitis C drugs. In addition to undergoing a clinical treatment, patients with hepatitis C should focus on caring for their liver.

What You Need to Know About Sustained Virologic Response (SVR)

If you’ve been researching hepatitis C, you may have heard about “sustained virologic response (SVR).” A virologic response refers to the presence of the hepatitis C virus being detected in the blood. If the virus cannot be detected in the blood after at least 12 weeks post-treatment, then a sustained virologic response has been achieved.

Having an SVR is essentially what it means to be “cured” of hepatitis C! Approximately 99% of people who experience a sustained virologic response live without the virus. Hepatitis C only returns in fewer than one percent of patients who achieve SVR. And, in many cases, that virus is actually the result of a new infection (i.e. being reintroduced to hepatitis C through a new exposure).

Once you achieve SVR you are no longer contagious, additional liver damage ceases, and liver function may improve. Not only does achieving SVR mean the virus is gone, but it also stops the progression of liver disease and other risks and complications associated with liver damage.

If you have been diagnosed with hepatitis C, help is available! Take action with your doctor today.

Get Care for Hepatitis C In Nashville

The care you need may be available at St. Thomas Medical Group. To learn more, schedule an appointment with a physician by calling +1 (615) 297-2700. You can also make an appointment online.