Iftikhar Pulwasha, Khatri Chander P, Nanduri Sri Ratna Divya, Ramzan Minahil, Sakalabaktula Krishna Sai Kiran
Obstetrics and Gynecology, City University of New York, New York, USA.
Internal Medicine, Marshall University, Huntington, USA.
Cureus. 2025 Jul 2;17(7):e87188. doi: 10.7759/cureus.87188. eCollection 2025 Jul.
Semaglutide and tirzepatide represent new treatment modalities for type 2 diabetes mellitus (T2DM) and obesity, expanding the range of glucagon-like peptide-1 (GLP-1) receptor agonists. Semaglutide is a GLP-1 receptor analog while tirzepatide is a dual agonist that targets both glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptors. Both are effective and well-tolerated treatments for managing T2DM and obesity, but their safety and effectiveness may vary across racial and ethnic groups. South Asians and Black individuals experience disproportionately higher rates of both obesity and diabetes compared to other racial and ethnic groups. These health disparities, along with socioeconomic barriers, highlight the urgent need for research to explore how semaglutide and tirzepatide perform across diverse populations. Asian populations, such as Japanese patients, appear to experience higher rates of gastrointestinal side effects with GLP-1 receptor agonists like semaglutide and tirzepatide compared to other groups. Additionally, South Asian adults who are older and have a lower BMI are more likely to discontinue the medication due to the heightened impact of side effects, particularly weight loss. Furthermore, Black populations also experience significant cardiovascular benefits with GLP-1 analogs, although the differences are less pronounced than in Asians. To ensure the best results, treatment plans should be tailored to the specific needs of individual patients, considering their ethnic backgrounds and socio-economic conditions, among other factors. This can be reinforced by improving patient education, offering support programs, and implementing policy changes to enhance medication adherence across diverse populations. Further research is needed to understand better how these factors vary across different populations and to optimize treatment strategies accordingly.
司美格鲁肽和替尔泊肽是2型糖尿病（T2DM）和肥胖症的新型治疗方式，扩展了胰高血糖素样肽-1（GLP-1）受体激动剂的范围。司美格鲁肽是一种GLP-1受体类似物，而替尔泊肽是一种双重激动剂，靶向葡萄糖依赖性促胰岛素多肽（GIP）和GLP-1受体。两者都是治疗T2DM和肥胖症的有效且耐受性良好的疗法，但它们的安全性和有效性可能因种族和族裔群体而异。与其他种族和族裔群体相比，南亚人和黑人肥胖症和糖尿病的发病率高得不成比例。这些健康差异以及社会经济障碍凸显了迫切需要开展研究，以探索司美格鲁肽和替尔泊肽在不同人群中的表现。与其他群体相比，亚洲人群，如日本患者，使用司美格鲁肽和替尔泊肽等GLP-1受体激动剂时胃肠道副作用的发生率似乎更高。此外，年龄较大且体重指数较低的南亚成年人由于副作用影响加剧，尤其是体重减轻，更有可能停药。此外，黑人人群使用GLP-1类似物也能获得显著的心血管益处，尽管差异不如亚洲人明显。为确保取得最佳效果，治疗方案应根据个体患者的具体需求进行定制，考虑其种族背景和社会经济状况等因素。这可以通过加强患者教育、提供支持项目以及实施政策变革以提高不同人群的药物依从性来强化。需要进一步研究以更好地了解这些因素在不同人群中的差异，并相应地优化治疗策略。
