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Early treatment with an SGLT2i alongside Metformin MR from diagnosis (with caution in frailty where there are risks such as volume depletion/hypotension) Absolutely great news, and this continues the shift from focusing solely on glycaemic control to prioritising cardiorenal protection from diagnosis
It usually occurs when I have larger meals than Im used to or hit the snack cabinet more frequently
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Important considerations include: Tirzepatide is not indicated for type 1 diabetes or diabetic ketoacidosis and is not a substitute for insulin No dose adjustment is required in renal impairment, but patients should be monitored for dehydration risk, particularly with significant gastrointestinal side effects Caution is advised in patients with a history of pancreatitis Warnings and precautions apply for patients with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 Prescribing in primary care requires initiation at 2.5 mg once weekly for 4 weeks (a non-therapeutic starting dose to improve tolerability), then escalation to 5 mg weekly
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