Podcast Summary: Taking Control Of Your Diabetes® – The Podcast!

Episode: GLP 1s – One Class of Drugs with Many Different Names

Hosts: Dr. Jeremy Pettus & Dr. Steve Edelman
Date: April 14, 2025

Overview

In this engaging and informative episode, Dr. Jeremy Pettus and Dr. Steve Edelman—both seasoned endocrinologists and people with type 1 diabetes—dive deep into the class of medications known as GLP-1 receptor agonists. Wielding both medical expertise and personal experience, they pit two blockbuster drugs—Ozempic and Mounjaro—against each other in a head-to-head competition across several key categories: A1C reduction, weight loss, heart and kidney protection, side effects, ease of use, and more. Their lighthearted but thorough discussion aims to clarify the latest science behind these medications while providing practical, real-world advice for people living with diabetes.

Key Discussion Points & Insights

1. Introduction & Cultural Context

• 00:00–02:48
  • Ozempic and Mounjaro have transcended the medical world, entering pop culture.
  • Both drugs started as treatments for type 2 diabetes and are now widely used for weight loss.
  • The real question: Which is better—and for whom?

2. GLP-1 Agonists Class: History & Mechanism

• 02:48–04:00
  • GLP-1s have revolutionized diabetes care, especially for type 2.
  • The original molecule was discovered in the saliva of the Gila monster.
  • Safety has been proven over 20 years of public use.

"You never know the true safety of a drug until it's been on the open market for a long time. And this class has." – Dr. Steve Edelman (03:47)

• Clinical pearl: Find a GLP-1 that works for you and stay on it—the benefits only last while you’re taking the medication.

3. Comparative Categories

Category 1: A1C Reduction

• 05:18–08:19
  • Mounjaro demonstrated a slightly greater reduction in A1C compared to Ozempic.
    • Mounjaro: ~2.3%
    • Ozempic: ~1.9%
  • Both are "unheard of" for their effect.
  • Mounjaro: able to normalize A1C in a significant percentage of users, sometimes dropping into non-diabetic ranges.

"This is almost like a complete metabolic reset for people." – Dr. Jeremy Pettus (07:26)

• Winner: Mounjaro

Category 2: Weight Loss

• 09:34–10:31
  • In head-to-head trials:
    • Mounjaro: average loss ~25 lbs
    • Ozempic: average loss ~13 lbs
  • Both drugs started with patients weighing just over 200 lbs.

"Both drugs have changed people's lives." – Dr. Steve Edelman (10:09)

• Winner: Mounjaro

Category 3: Heart Protection

• 10:31–14:20
  • Ozempic has officially demonstrated cardiovascular risk reduction and has the FDA indication.
  • Mounjaro’s studies are underway but not yet published.
  • The official data gives Ozempic an edge for patients with both diabetes and heart disease.

"If you wanna go by the book, these indications—then Ozempic is the choice for you." – Dr. Jeremy Pettus (14:02)

• Winner: Ozempic

Category 4: Kidney Protection

• 14:25–15:58
  • Ozempic has been proven (via the FLOW study) to reduce the progression of kidney disease and now has the FDA stamp.
  • Mounjaro’s studies in this area are pending.

"They took people with underlying kidney disease, if they got Ozempic, did better in terms of reducing the progression of kidney disease." – Dr. Jeremy Pettus (15:18)

• Winner: Ozempic

Category 5: Side Effects

• 16:37–20:38
  • Both medications primarily cause gastrointestinal side effects (nausea, constipation, vomiting), usually during initial titration.
  • Studies say Mounjaro has higher rates, but real-world clinical experience suggests it’s a tie.
  • Gradual dose escalation helps manage side effects for both.

"The slower you go, generally, you can avoid these side effects." – Dr. Jeremy Pettus (17:30)

• Clinical Tie; if forced, Ozempic might edge slightly ahead in trial data.

Category 6: Obstructive Sleep Apnea

• 21:09–23:25

  • Mounjaro recently received indication for reducing sleep apnea severity, likely due to weight loss.
  • Expanding indications allow more patients to access the drug through insurance.
  • Ozempic and Mounjaro also have different brand names when used for obesity (Wegovy and Zepbound, respectively).

• Winner: Mounjaro

Category 7: Ease of Use (Pen Devices)

• 23:25–26:28
  • Mounjaro: Auto-injector pen, very simple, fixed dose.
  • Ozempic: Dial-a-dose pen, allows fine-tuned titration.
  • Patients benefit from different approaches, depending on their preference and sensitivity to side effects.

"Ozempic ... opens up more options for dosing ... gives you a rainbow of doses." – Dr. Jeremy Pettus (24:22)

• Clinical Tie: Ease is subjective—auto-injector vs. customizable doses.

Category 8: Type 1 Diabetes Access

• 26:28–30:56
  • Frustratingly, GLP-1s are not officially indicated for type 1 diabetes, despite evidence they offer benefit.
  • Insurance coverage is the main barrier; studies are planned for Mounjaro in type 1.
  • Some type 1s can access meds through obesity indications or specific insurance codes.

"If you have type one, we know we're the most important ... Super elite club." – Dr. Steve Edelman (29:04)

• Winner: Mounjaro (for making moves toward studies and approvals in type 1).

Category 9: Other Indications & New Frontiers

• 30:57–33:21
  • Both drugs show promise for prediabetes, fatty liver, osteoarthritis, and even addiction reduction.
  • Treating prediabetes could have massive public health benefits.

"What a way to reduce not only healthcare costs, but improve the lives of people who may go on to develop type 2 and all the associated side effects or complications." – Dr. Steve Edelman (32:13)

Notable Quotes & Moments

• On the origin of GLP-1 drugs:
  "In the saliva of the Gila monster. Not the venom that you said on the first show." – Dr. Steve Edelman (03:38)

• On the importance of sticking with it:
  "People, after they're given a GLP-1, only about a third ... are on it a year later ... All these effects ... only work as long as you take the drug." – Dr. Jeremy Pettus (04:00)

• On weight loss mechanism:
  "You get full faster ... The way people lose weight is they eat less. And that's the duh moment." – Dr. Jeremy Pettus (19:20)

• On clinical differences:
  "There’s more similarities than differences. As long as you can get to a reasonable dose and maintain it, that is by far the most important thing." – Dr. Jeremy Pettus (33:13)

Timestamps for Key Segments

• Main introduction & background: 00:00–03:38
• GLP-1 mechanism, history, and safety: 03:38–05:18
• Category 1: A1C reduction: 05:18–08:19
• Category 2: Weight loss: 09:34–10:31
• Category 3: Heart protection: 10:31–14:20
• Category 4: Kidney protection: 14:25–15:58
• Category 5: Side effects: 16:37–20:38
• Category 6: Sleep apnea indication: 21:09–23:25
• Category 7: Pen device/ease of use: 23:25–26:28
• Category 8: Type 1 access: 26:28–30:56
• Other indications and closing thoughts: 30:57–34:13

Final Takeaway

Drs. Pettus and Edelman highlight that while Mounjaro often has an edge in A1C and weight loss, Ozempic leads in proven heart and kidney protection—though this may eventually change as more studies are released. Both GLP-1 drugs offer tremendous health benefits, with ongoing research likely to expand their approved uses even further. Ultimately, the “best” drug is the one patients can obtain, tolerate, and stick with for the long term.

"They're both tremendous additions and there's more similarities than differences." – Dr. Steve Edelman (33:21)

Recommended for: Anyone curious about diabetes medications, clinicians, people living with diabetes or obesity, and anyone keeping an eye on the cutting edge of chronic disease management.