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Whilst the resources necessary to deploy this render it likely unachievable in most clinical settings, it supports the concept that a targeted approach to correcting pathophysiology is beneficial
The major clinical concerns with sulfonylureas are hypoglycemia and weight gain
Severe or recurrent genital mycotic infections and urinary tract infections warrant treatment suspension if they become problematic ( Canagliflozin specifically should be discontinued in patients with a heightened risk of amputations, including those with a history of amputations, severe peripheral neuropathy, severe peripheral arterial disease, or active lower-limb ulcers or infections, as well as in individuals with an increased fracture risk, particularly those with previous osteoporotic fractures ( 3.3 Mechanism of action of GLP1 receptor agonists GLP-1 is a hormone belonging to the incretins that is produced in the gastrointestinal tract, by L cells, in response to the intake of nutrients, especially fat and glucose ( GLP-1 RAs like liraglutide and semaglutide, offer a therapeutic advantage over native GLP-1 by being resistant to degradation by dipeptidyl peptidase-4 (DPP-4)
Tirzepatide is the first dual glucose-dependent insulinotropic polypeptide (GIP)/GLP- 1 receptor co-agonist approved for the treatment of T2DM in the USA, Europe, and the United Arab Emirates [4]
Previously, the distribution and delivery of Wegovy were fully subject to cold chain, meaning the medicine had to be kept cold from where it is made to where it is used
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