Dr Paramesh Shamanna M.D.

Diabetologist | Medical Researcher | Pioneering Diabetes and Metabolic Disease Reversal

[Dr. Shashank Joshi @AskDrShashank]

Early study …One group of Researchers discovered why some people lose weight faster than others on GLP-1 drugs, while others are more vulnerable to adverse reactions

Variations in two genes involved with hormones in the gut, which regulate appetite and digestion, could play a role in how these drugs work.. long way to go for personalised care @TheAACE @TheEndoSociety

[Dr Paramesh Shamanna M.D. @drparamesh2]

Check out my latest article: India’s GLP-1 and GIP Market Has Reached an Inflection Point—But Prescribing Is Still Urban and Specialist-Led https://t.co/FL5m5AJYG0 via @LinkedIn

[Dr Paramesh Shamanna M.D. @drparamesh2]

Weak quadriceps may be one of the most ignored warning signs in longevity.

Not just a fitness issue.
Low quad strength can reflect declining mobility, frailty, metabolic reserve, and independence.

After 50, leg strength training is not optional.
It is prevention.

#Longevity #HealthyAging #Sarcopenia #Frailty

[Dr Paramesh Shamanna M.D. @drparamesh2]

a dubious profile having changed 19 usernames and been active only since April 2025 and is fully full of Hinduphobic posts, who doesn't appear to be belonging to South India, writes a post trying to divide the North and South and the post is made viral and an article prominently projecting her post is written. Is this right for a reputed site such as MoneyControl?

[Dr Paramesh Shamanna M.D. @drparamesh2]

Why “glucagon-like peptides” if they don’t act like glucagon?

Because GLP-1 & GLP-2 share the same parent molecule (PROGLUCAGON) and partial sequence similarity, but they’re processed in different tissues (gut L-cells vs pancreatic α-cells) and act on different receptors.

Same precursor ≠ same function.
#Diabetes #Endocrinology #GLP1 #GLP2 #Glucagon
Proglucagon is cut in pancreas → glucagon (raises glucose) and in intestine → GLP-1 (lowers glucose) + GLP-2 (gut repair/absorption).

[Dr Paramesh Shamanna M.D. @drparamesh2]

@SanskritChannel @davidfrawleyved 700

[Dr Paramesh Shamanna M.D. @drparamesh2]

Heartiest congratulations to my mentor, Dr Shashank R. Joshi, on being selected to deliver the Hossein Gharib, MD, Lectureship at the 2026 AACE Annual Meeting in Las Vegas. 🌏🏅

This prestigious honour is a powerful recognition of his lifelong contributions to thyroid disease, iodine nutrition, and clinical endocrinology—both in India and globally. I have been privileged to learn from his clinical wisdom, academic rigor, and tireless commitment to patient care and education.

Wishing him the very best for his lecture on “Impact of Iodine on Thyroid Autoimmunity, Goiter, and Oncogenesis.” Looking forward to listening and continuing to learn from him.

#AACE2026 #Endocrinology #Thyroid #MedicalLeadership #ProudMoment

[Dr Paramesh Shamanna M.D. @drparamesh2]

💡 Take-home
Unprocessed red meat is not an independent driver of obesity.
But cholesterol effects matter → especially in cardiometabolic risk groups.

Time to rethink long-standing dietary dogma?

🔗 DOI: https://t.co/2rm709688Y

4/4 🧵

[Dr Paramesh Shamanna M.D. @drparamesh2]

🥩🚨 Belief-shaking evidence on red meat & obesity
A 2025 meta-analysis of RCTs (Obesity, DOI: 10.1002/oby.24322) finds:
👉 Unprocessed red meat (URM) does not increase BMI, weight, or fat %

1/4 🧵

[Dr Paramesh Shamanna M.D. @drparamesh2]

⚖️ Key results
✅ No effect on BMI, weight, or fat %
✅ URM is obesity-neutral
⚠️ Slight ↑ in total cholesterol & LDL in filtered analyses

3/4 🧵

[Dr Paramesh Shamanna M.D. @drparamesh2]

🥩🚨 New evidence challenges dogma:
A 2025 meta-analysis of RCTs finds unprocessed red meat does NOT increase BMI, weight, or body fat.

⚠️ Slight ↑ in LDL/TC, but no obesity effect.

Time to rethink red meat & obesity?
DOI: 10.1002/oby.24322

#Obesity #RCT #Nutrition

[CME INDIA @CMEINDIA1]

“Tirzepatide Shown to Tackle Hypogonadism” from ENDO 2025:

📰 CME INDIA – Clinical Pearls: Tirzepatide in Obesity-Associated Hypogonadism
@Rssdi_official
@IndiaESI @AskDrShashank @banshisaboo @DrAmbrishMithal
@dramitaol @KapoorNitinDr @DrShubhaSandill @DrKhushboo_Endo
@📌 Key Takeaways:

Metabolic hypogonadism in obese men is an underdiagnosed but clinically significant condition, closely linked with insulin resistance and increased diabetes risk.

Tirzepatide (TZP), a dual GIP/GLP-1 receptor agonist, was associated with robust improvements in body composition and gonadal hormones over 2 months:

Significant reductions in weight, waist circumference, binge eating scores (BES), and fat mass.

Improvements in total and bioavailable testosterone (TT), LH, FSH, and SHBG.

Greater benefits than lifestyle interventions alone or transdermal testosterone replacement.

Testosterone replacement therapy (TRT) corrects hypogonadism but does not address underlying obesity and insulin resistance.

Tirzepatide may "restore" endogenous hormonal function, potentially breaking the vicious cycle of obesity → insulin resistance → hypogonadism.

💡 Clinical Insights:

✅ Why does this matter?

Obesity suppresses the hypothalamic-pituitary-gonadal (HPG) axis, resulting in low testosterone.

Restoring testosterone without treating obesity perpetuates underlying metabolic dysfunction.

TZP addresses both metabolic derangements and hypogonadism.

✅ Possible mechanisms:

Weight loss and reduction in visceral adiposity may relieve suppression of the HPG axis.

Unclear if tirzepatide exerts direct action on HPG axis independent of weight loss — warrants further mechanistic studies.

✅ Patient selection:

Ideal candidates: Men with obesity-related functional hypogonadism not seeking fertility.

Caution: Study excluded patients on common comorbidity medications (e.g., antihypertensives, statins, antidiabetics), so results may not generalize broadly yet.

🔔 Critical limitations:

Small, non-randomized pilot study (n=83, 2-month duration).

No placebo group.

Durability and long-term safety need confirmation before routine clinical adoption.

Not powered to determine direct versus weight-loss-mediated effects.

📝 Practice Implications:

🔹 Lifestyle modification remains first-line for obesity-related hypogonadism.

🔹 Tirzepatide may emerge as a preferred metabolic-hormonal rebalance strategy if larger, long-term studies confirm benefits.

🔹 TRT should not be used reflexively in obese hypogonadal men — address weight and insulin resistance first.

✅ Conclusion:
Tirzepatide offers a novel, potentially disease-modifying approach for functional hypogonadism in obese men, superior to TRT alone, but should be used cautiously pending larger randomized trials.

📖 Reference:
📎 Full article: MedCentral – Tirzepatide and Hypogonadism
🔗 Study link: DOI: 10.1186/s12958-025-01425-9

[Dr Paramesh Shamanna M.D. @drparamesh2]

@KapoorNitinDr Congratulations Dr Nitin the topic of your paper is the need of the hour

[Dr Paramesh Shamanna M.D. @drparamesh2]

Honored to be part of the Workshop on Health at the Indian Institute of Science on March 14-15, 2025.

I spoke on the impact of the environment on diabetes, exploring how climate change, pollution, and lifestyle shifts influence metabolic health. As the climate crisis intensifies, addressing its role in chronic diseases is more crucial than ever.

Grateful for the insightful discussions and collaborations!

#ClimateAndHealth #Diabetes #IISc #EnvironmentalHealth #SustainableHealth