Complementary approaches may include: Behavioral therapy or weight management counseling Sleep optimization (79 hours nightly) Stress management techniques Evaluation and treatment of coexisting conditions (insulin resistance, sleep apnea, depression) FDA-approved oral weight loss medications (orlistat, phentermine/topiramate ER, naltrexone/bupropion) as alternatives to injectables (note: phentermine monotherapy is approved for short-term use only) Patients should maintain realistic expectationsweight loss may be slower with hypothyroidism, even when well-controlled
CVB has been reported to infect multiple human cell types associated with T1D, including primary islets, human pluripotent stem cell-derived islets, ductal cells, thymic epithelial cells, thymic fetal cells, and human PBMCs ( Enteroviruses must attach to and enter a host cell to initiate viral replication
We also saw shortages that left diabetic patients unable to fill prescriptions because the supply was diverted to off-label weight loss use
However, vitamin B12 shots may have other side effects
Some patients may receive higher or lower doses than prescribed
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