Metabolic Revolution: Redefining Endocrinology with Novel Incretin-Based Therapies

Abstract

The present multinational study evaluated the comprehensive metabolic, cardiovascular, renal, and hepatic effects of incretin-based therapies in adults with obesity and type 2 diabetes mellitus (T2DM) across Mexico, Colombia, and Ecuador. After 12 months of treatment, participants exhibited consistent and clinically significant improvements in all outcome domains. Mean body weight decreased by 10.7%, HbA1c by 1.3 percentage points, and fasting glucose by 23.5%, accompanied by favorable reductions in blood pressure and lipid levels. Estimated glomerular filtration rate (eGFR) improved (+2.3 mL/min/1.73 m²), while albuminuria declined (−14 mg/g), reflecting strong renal protection. Hepatic parameters, including ALT, CAP score, and fibrosis indices (FIB-4, NFS), also improved, suggesting regression of steatosis and early fibrosis. The incidence of major adverse cardiovascular events (MACE) was 2.6%, with no significant differences between countries (p > 0.05), confirming regional reproducibility. Collectively, these findings demonstrate that incretin-based pharmacotherapy provides integrated metabolic and multiorgan protection, in line with evidence from pivotal trials such as STEP, SURPASS, SELECT, and FLOW. The uniform outcomes across nations highlight its potential scalability in Latin America, supporting incorporation into regional health programs for diabetes, obesity, and metabolic dysfunction–associated steatotic liver disease (MASLD). Incretin-based therapies therefore represent a transformative paradigm in modern endocrinology—uniting glycemic control, weight management, and organ preservation under a single therapeutic strategy.