Dr. Karan Lal Shares 'Recipe' for Prescribing GLP-1s

The increasingly understood relevance of weight-loss drugs to inflammatory skin conditions was a hot topic at the Skin of Color Update in New York, New York, and Karan Lal, DO, FAAD, shared his “recipe” for addressing it with patients.

Dr. Lal first checks for prior diagnoses of diabetes mellitus, hypertension, or hyperlipidemia, and assesses body mass index and weight. If a dermatologist does not feel comfortable prescribing a GLP-1 agonist based on these factors, Dr. Lal suggested refering to a primary care physician or endocrinologist.

“You don’t have to assume that responsibility,” Dr. Lal said.

If unsure, Dr. Lal said, he checks HgbA1c, BMP, CRP, BP, and AST/ALT levels at baseline.

The next step is ensuring that the patient has no history (or family history) of multiple endocrine neoplasia or medullary thyroid cancer.

Dr. Lal then discusses the risks of pulmonary aspiration, bowel obstruction, and nonarteritic anterior ischemic neuropathy with the patient.

Finally, Dr. Lal said, he counsels patients that they will still need to eat even if they do not feel hungry while on the medication. He advises that they should aim to maintain a 1,200-calorie diet.

Dr. Lal reiterated that dermatologists either should be ready to prescribe GLP-1 agonists themselves or should refer to others who will.

“People want to use these drugs,” he said.