It is a triple agonist that also activates GIP and glucagon receptors, giving it metabolic advantages that semaglutide cannot match
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refer for retinal screening refer for DESMOND or equivalent modified release metformin and a sodiumglucose cotransporter-2 (SGLT-2) is generally the first line treatment option in type 2 diabetes (1) NICE suggest targets for management of type 2 diabetes as (1) Targets for adults whose type 2 diabetes is managed either by healthy living and diet, or healthy living and diet combined with an initial medication regimen that is not associated with hypoglycaemia, support them to aim for an HbA1c level of 48 mmol/mol (6.5%) for adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53mmol/mol (7.0%) in adults with type 2 diabetes, if HbA1c levels are not adequately controlled by a single drug and rise to 58 mmol/mol (7.5%) or higher: reinforce advice about diet, lifestyle and adherence to drug treatment and support the person to aim for an HbA1c level of 53mmol/mol (7.0%) and intensify drug treatment consider relaxing the target HbA1c level on a case-by-case basis, with particular consideration for people who are older or frail, for adults with type 2 diabetes: who are unlikely to achieve longer-term risk-reduction benefits, for example, people with a reduced life expectancy for whom tight blood glucose control poses a high risk of the consequences of hypoglycaemia, for example, people who are at risk of falling, people who have impaired awareness of hypoglycaemia, and people who drive or operate machinery as part of their job for whom intensive management would not be appropriate, for example, people with significant comorbidities if adults with type 2 diabetes achieve an HbA1c level that is lower than their target and they are not experiencing hypoglycaemia, encourage them to maintain it
Serious heart valve problems or disease have been reported in patients taking a combination of phentermine and fenfluramine or dexfenfluramine for weight loss
In any proper GLP-1 comparison , this shared mechanism is the starting point
