{"id":1849,"date":"2024-12-24T11:40:59","date_gmt":"2024-12-24T11:40:59","guid":{"rendered":"https:\/\/retirednurseblog.com\/index.php\/2024\/12\/24\/some-patients-want-to-take-a-holiday-pause-on-diabetes-or-weight-loss-drugs-heres-what-doctors-say-they-need-to-know\/"},"modified":"2024-12-24T11:40:59","modified_gmt":"2024-12-24T11:40:59","slug":"some-patients-want-to-take-a-holiday-pause-on-diabetes-or-weight-loss-drugs-heres-what-doctors-say-they-need-to-know","status":"publish","type":"post","link":"https:\/\/retirednurseblog.com\/index.php\/2024\/12\/24\/some-patients-want-to-take-a-holiday-pause-on-diabetes-or-weight-loss-drugs-heres-what-doctors-say-they-need-to-know\/","title":{"rendered":"Some patients want to take a holiday pause on diabetes or weight-loss drugs. Here\u2019s what doctors say they need to know"},"content":{"rendered":"

Around the holidays, when many people are baking cookies for Santa, enjoying cocktail parties or having festive family feasts, some adults who use popular medications for diabetes or weight loss explore skipping doses for a week or two. <\/p>\n

These medications can suppress appetite or sometimes cause uncomfortable side effects that some people might want to avoid during the holiday season. And according to some doctors, some of their patients have said they want to fully delight in their favorite foods or just save some money during a season of high spending. <\/p>\n

\u201cPeople are bound to wonder about doing this,\u201d said Dr. Judith Korner, professor of medicine in the Division of Endocrinology at New York Presbyterian\/ Columbia University Irving Medical Center in New York. <\/p>\n

\u201cSometimes they think about it if they\u2019re going on a cruise or a vacation,\u201d she said. \u201cI have patients who are in the other situation, where they have been going up on the medication and we have kept them at their current dose and we\u2019re not escalating during the holidays.\u201d <\/p>\n

Dr. Alyssa Dominguez, an endocrinologist with Keck Medicine of USC in Los Angeles, says some of her patients also ask about pausing doses during the holidays. <\/p>\n

\u201cPatients have come to me asking about skipping doses of these medications around the holidays, around vacations. Another thing that often comes up is delay of either starting the medication or escalating the dose of a medication,\u201d Dominguez said. <\/p>\n

\u201cIt is not uncommon for somebody to want to hold the dose or hold off on a dose escalation,\u201d she said. \u201cThese medicines have side effects such as nausea, stomach pain, constipation or diarrhea. So, certainly, if somebody was thinking about starting the medication as a new start or increasing the dose, it\u2019s totally understandable why somebody would not want to be experiencing those symptoms if they\u2019re going to be on a plane for a long time or in a foreign country.\u201d <\/p>\n

Additionally, if these medicines are not covered by insurance, they can be expensive \u2013 ranging from several hundred dollars to about $1,000 a month. <\/p>\n

Different risks for different people<\/h2>\n

GLP-1 receptor agonists and dual agonists \u2013 such as Ozempic, Wegovy, Mounjaro and Zepbound \u2013 are typically used as weekly injections. The GLP-1 receptor agonists work by mimicking the GLP-1 hormone in the gut, and the dual agonists work by mimicking both the GLP-1 and GIP hormones, which regulate blood glucose and appetite. <\/p>\n

In most cases, when people start on these medications, they are prescribed low doses and gradually increase to higher doses in the following weeks. <\/p>\n

But the effects that a pause may have on your body depends on why you\u2019re taking the medication in the first place, Korner said. <\/p>\n

\u201cIf you\u2019re taking the medication to control your blood sugar because you have type 2 diabetes, you have to realize if you\u2019re skipping a dose, that your blood glucose is going to become higher,\u201d she said. \u201cBut if you are very well-controlled with type 2 diabetes and your blood sugar goes a little bit higher, that may not be clinically that significant.\u201d <\/p>\n

Dominguez said the risk of elevated blood sugar levels would be a concern if someone with diabetes skips a dose. But for other people who are using these medications specifically for weight loss, the risks would be different. <\/p>\n

\u201cWe would expect that a person would have less appetite suppression and more quick stomach emptying, so they would likely be able to eat more, which may interfere with some weight loss efforts\u201d by raising the risk of overeating, Dominguez said. <\/p>\n

However, \u201cthese medications stay in your body for a while. So even if you skip one dose, it\u2019s not like the levels of the medication go down to a complete zero,\u201d Korner said. \u201cYou will still have some of the medication in your system, so you may still have an effect helping to control your appetite. These are things to consider.\u201d <\/p>\n

The prescribing information for Ozempic notes that if someone misses a dose, they should take it within five days. If more than five days have passed, the person should skip the missed dose and administer the next on the regularly scheduled day. <\/p>\n

It\u2019s similar for Mounjaro and Zepbound. The prescribing information advises taking a skipped dose within four days, but if more than four days have passed, the missed dose should be skipped and the next given on the regularly scheduled day. <\/p>\n

The prescribing information for Wegovy notes that if one dose is missed and the next is more than two days away, the patient should take the missed dose as soon as possible. But if the next dose is less than two days away, they should not take the skipped dose and resume their regular schedule. <\/p>\n

For many of these medicines, \u201cyou can miss up to two weeks of your medication without having to go back down to a lower dose. So, from a safety standpoint, it\u2019s manageable,\u201d said Dr. Deborah Horn, director of obesity medicine at UTHealth Houston in Texas. <\/p>\n

\u201cHowever, I wouldn\u2019t recommend someone skipping their dose just because they want to have a little more in the holiday season,\u201d she said. \u201cWe do worry that beyond two weeks, you have a much higher risk of having side effects, even if you didn\u2019t have them as you were dose-escalating the first time,\u201d such as nausea, constipation, diarrhea or vomiting. <\/p>\n

\u2018The holidays aren\u2019t always just about food\u2019<\/h2>\n

For many patients, maintaining their dose schedules is helpful during the holidays. <\/p>\n

\u201cPeople actually, at least in my patient population, they actually would rather stay on it, because the holidays are tough, right?\u201d said Dr. Eduardo Grunvald, medical director of the Center for Advanced Weight Management at the UCSD Bariatric and Metabolic Institute. <\/p>\n

Some providers said they guide their patients about how to stay on the medications and still enjoy their favorite treats, for example, by trying smaller portion sizes. <\/p>\n

\u201cKeep that meal size at a place where you can tolerate it. We know that if you eat too much on these GLP-1 medications, it can bring on nausea or uncomfortable abdominal pain,\u201d Horn said. \u201cJust be careful about the volume.\u201d <\/p>\n

For some people, it helps to eat every four hours, which can reduce the risk of side effects, she said. \u201cSome people can struggle with nausea and some of these GI side effects if they go long periods of time without eating.\u201d <\/p>\n

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