Stavros Tsipas

Background: The clinical use of antidiabetic drugs (ADDs) has gained prominent public visibility due to the Food and Drug Administration (FDA) expansion of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in recent years; these drugs are now widely prescribed for weight loss. This shift is reflected in online public discourse. Objective: This study aimed to analyze the current online public discourse surrounding ADDs, with an emphasis on perceptions of insulin versus noninsulin therapies and the increasing prominence of weight loss–associated medications. Methods: We conducted a retrospective analysis of 23,580 English-language posts from the United States in 2023, using Boolean keyword searches to examine conversations about insulin-inclusive, with or without weight loss terms, and insulin-exclusive, with or without weight loss terms. We analyzed the volume and sentiment of online conversations regarding ADDs, frequency of drug mentions, proportion of posts by self-identified physicians, and thematic analysis of patient and clinician concerns. Results: A total of 26,832 initial posts were collected in 2023. After post validation, 23,580 posts remained as the study sample size. Of the 23,580 posts, 4.6% (1087/23,580) mentioned insulin, and 95.4% (n=22,493) did not mention insulin. Semaglutide-containing drugs such as Ozempic and Mounjaro were the most referenced medications, particularly in weight-loss contexts. Weight loss conversations made up the majority of online posts. Conversations about insulin were marginal compared with conversations that did not mention insulin online. Only 7% to 10% of posts came from self-identified physicians. Key themes included drug accessibility, off-label use for weight management, concerns about supply shortages, insurance coverage, and growing calls for holistic care. Notably, public perspectives favored the dual efficacy of medications like Ozempic in managing diabetes and promoting weight loss. Conclusions: The discourse on ADDs is dominated by weight loss–oriented therapies, with GLP-1 RAs driving much of the engagement. This surveillance paper illustrates the current state of public health interests around antidiabetic medications associated with weight loss and raises concerns regarding equitable access for patients with diabetes. These findings underscore the need for updated clinical guidance on necessary lifestyle behaviors for antidiabetic medication use and ongoing monitoring of public opinions regarding chronic disease management medications.

Background: This study assessed differences in blood pressure control rates and systolic blood pressure (SBP) values at Cook County Health (CCH) implementing the AMA MAP™ Hypertension quality improvement program, with the goal of identifying variations across demographic subgroups including race, ethnicity, sex and age. Methods: We conducted a retrospective cohort study at CCH, comparing a 2-year historical pre-intervention with a subsequent 2-year period encompassing implementation and post implementation. Within each demographic subgroup, control rates were calculated as proportion of patients with controlled blood pressure. Univariate analyses assessed changes in blood pressure (BP) control over time. Prevalence ratio estimates were calculated to understand likelihood of having controlled blood pressure. Paired t-tests evaluated within-group changes in SBP, and an ANCOVA was conducted to compare SBP changes between groups while adjusting for baseline SBP. Results: Overall, blood pressure control rates increased over time. However, Black patients were less likely than White patients to have controlled blood pressure both before (PR 0.91 [CI: 0.87-0.96]) and after (PR 0.96 [0.92—0.99]) the implementation of the program. SBP improved across all demographic groups, including Hispanic (-5.74 [CI:6.19- -5.29]) and Non-Hispanic patients (-4.92 [-5.21- -4.63]), White (-5.96 [CI: -6.45- -5.47]) and Black (-4.80 [CI: -5.11- -4.49]) patients, and patients 45-64 years of age (-5.79 [CI: -6.12- -5.46]) and patients 65-85 years of age (-4.31 [CI: -4.68- -3.94]). Conclusions: The AMA MAP™ Hypertension quality improvement program led to improvements in blood pressure control; however, gaps persisted in SBP values between ethnicity, race and age.

BACKGROUND The clinical use of anti-diabetes drugs (ADDs) has expanded significantly in recent years, as glucagon-like peptide-1 (GLP-1) receptor agonists are now widely prescribed for weight loss. These shifts may be altering public perceptions and affecting diabetes treatment accessibility. OBJECTIVE To analyze the current online public discourse surrounding ADDs, with emphasis on perceptions of insulin versus non-insulin therapies and the increasing prominence of weight loss-associated medications. METHODS We conducted a retrospective analysis of 25,401 English-language tweets from the U.S. in 2023, using Boolean keyword searches to examine conversations about insulin-inclusive with/without weight loss terms, and insulin-exclusive with/without weight loss terms. We analyzed volume and sentiment of online conversations regarding ADDs; frequency of drug mentions; proportion of tweets by self-identified physicians; and thematic analysis of patient and clinician concerns. RESULTS 26,832 tweets were collected in 2023. After tweet validation, 1,087 tweets mentioned insulin, and 22,493 tweets did not mention insulin.. Semaglutide-containing drugs such as Ozempic and Mounjaro were the most referenced medications, particularly in weight-loss contexts. Conversations about insulin-based therapies have declined compared to 2019. Only 7–10% of tweets came from self-identified physicians. Key themes included drug accessibility, off-label use for weight management, concerns about supply shortages, insurance coverage, and growing calls for holistic care. Notably, public sentiment favored the dual efficacy of medications like Ozempic in managing diabetes and promoting weight loss. CONCLUSIONS The discourse on ADDs has shifted towards weight-loss-oriented therapies, with GLP-1 agonists driving much of the engagement. This change reflects the evolution in public health interests and raises concerns regarding equitable access for diabetes patients. These findings underscore the need for updated clinical guidance, policy adaptations, and ongoing monitoring of public sentiment regarding chronic disease management medications.