It’s not just obesity. Ozempic and its cousins will change the world本篇主要说好似万能药的GLP-1，目前用在治疗肥胖的semaglutide和治疗2型糖尿病的Ozempic中都含有GLP-1，好像还可以治疗心血管和肾脏疾病，阿尔兹海默症，成瘾，但还在研发中
万能药好像出现了：First the drugs tackled diabetes. Then, with just an injection a week, they took on obesity. Now they are being found to treat cardiovascular and kidney disease, and are being tested for Alzheimer’s and addiction. It is early days yet, but GLP-1 receptor agonists have all the makings of one of the most successful classes of drugs in history.竟然有这么好的药吗？不知道贵不贵？
知识补充1：GLP-1 激动剂最初是为 2 型糖尿病开发的。2022 年美国糖尿病协会医疗标准推荐将 GLP-1 激动剂作为 2 型糖尿病的一线治疗，特别是对于动脉粥样硬化性心血管疾病或肥胖症患者。这些药物还被认为可以显着减少食物摄入量和体重，有些药物还被批准用于在没有糖尿病的情况下治疗肥胖症。它们还在开发用于其他适应症，例如非酒精性脂肪肝病、多囊卵巢综合征和奖励系统疾病，例如成瘾。
知识补充2：糖尿病治疗路径可总结为：1.强调生活方式干预；2.及早检查，及早治疗；3.一般是先口服，再注射（越来越强调早期胰岛素强化）；4.降糖和并发症预防双管齐下；5.关注心脑血管获益；体重管理。目前国内在使用的口服降糖药主要有双胍类、格列奈类、DPP-4抑制剂、SGLT-2抑制剂、GLP-1受体激动剂等；糖尿病注射制剂主要为GLP-1及胰岛素（这个药竟然是口服和注射都有）
知识补充3：根据国际糖尿病联盟（International Diabetes Federation）的研究，预计到2045年糖尿病患者人数将从目前的4.63亿增长至7亿。2019年统计数据显示：糖尿病患者人数，中国排名第一，总人数约1.164亿人；根据《2020中国2型糖尿病防治指南》显示，我国糖尿病患病率已高达11.2%，其中2型糖尿病患者占90%以上。这一巨大需求市场，萌生多家重磅GLP-1新药。经摩熵医药（原药融云）数据库查询显示，索马鲁肽进入医保前价格：1.5ml为1120元/支；3ml/为1904元/支。降价后，3ml/支预计价格为：890元/支，降价幅度超过53%。
美国肥胖问题及治疗：Already one in eight American adults has been on GLP-1 drugs. With over two fifths of the world overweight or obese, demand for GLP-1 drugs is voracious.肥胖竟然这么普遍
Novo Nordisk, maker of semaglutide, branded Ozempic for diabetes and Wegovy for weight loss, and Eli Lilly,which makes tirzepatide, a more effective alternative, have together added around $1trn in market value since 2021.所以这些药中都需要 GLP-1，难怪这么厉害，但是只有两家制药公司，说明价格还在垄断地位
药物Semaglutide 在中国快到期：Semaglutide is to come off patent in Brazil, China and India in 2026; eight such drugs are in the works in China.那就是药物的产权到期了，可以研制仿制药了？
为什么这么厉害？As our briefing explains this week, not only do the drugs act in the gut, but they also bind to receptors all over the body and in the brain.不仅肠道起作用还在全身和大脑中的受体结合（虽然不懂但好厉害的样子）
药物价格昂贵：For now the drugs are expensive: tirzepatide is priced at over $500 a month in America.Their immediate side-effects, which can include nausea, pancreatitis, diarrhoea and muscle loss, may be off-putting; the effects from decades of taking them are uncertain.且有副作用
In 2019 heart disease, stroke, diabetes, Alzheimer’s and kidney disease ranked among the top ten global causes of death. Last year more than 100,000 Americans were killed by opioid overdoses and 180,000 died from drink.糖尿病不是慢性病吗？怎么也排在十大死亡愿意之列？？？另外美国人这么喜欢喝酒吗?18万死于饮酒
Rather as the contraceptive pill encouraged women to stay in education and work, so GLP-1 drugs could lead to profound economic and social change by enhancing productivity and freedom.用避孕药类比绝了，我一下就get到了
Obesity and addiction may less often be seen as moral failings, but as illnesses that can be treated. 我以为肥胖在国内才被歧视，不过感觉是肥胖女孩会被歧视，肥胖的男孩一大堆，没想到在美国竟然也会