Related Experiment Videos
Why do some patients thrive on GLP-1 therapy while others do not? An ayurvedic perspective on metabolic heterogeneity
1Center for Community Hospital Medicine, UPMC Passavant Hospital, Pittsburgh, PA, USA; ServeFed - Federal Occupational Health, USA; Purighalla Wellness LLC, Allison Park, PA, USA.
Abstract:
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the treatment of obesity and type 2 diabetes, yet individual responses vary substantially. Some patients achieve marked improvements in glycemia, weight, and cardiometabolic risk, whereas others have limited benefit, gastrointestinal intolerance, excessive weight loss, or clinically concerning loss of lean tissue. Genetics may explain part of this heterogeneity, but Ayurveda suggests an additional question: are we applying the same metabolic intervention to patients with meaningfully different digestive, nutritional, and metabolic phenotypes? Ayurveda has long described prameha as heterogeneous and evaluates agni (digestive and metabolic capacity), ama (incompletely processed or accumulated material), srotas (pathways of transport), and suitability for langhana (reducing or lightening therapy) before selecting treatment. These concepts should not be equated literally with modern biomarkers. Rather, they provide a framework for a testable contemporary hypothesis: identifying and, where possible, modifying gastrointestinal, nutritional, and metabolic phenotypes before and during GLP-1 therapy may improve tolerability and the quality of response.
Related Concept Videos
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
Hypoglycemia and Glucagon
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Oral Hypoglycemic Agents: Glinides
Oral Hypoglycemic Agents: Biguanides and Glitazones
Dipeptidyl Peptidase 4 Inhibitors