This article originally posted 16 August, 2012 and appeared in Issue 639
SPECIAL GLP-1 Test Your Knowledge #639: Patient Questions on GLP-1
PharmD candidate, University of Florida, Richard Aramini
Your patient, DM, is a 66-year-old white male who was diagnosed with type 2 diabetes 5 years ago. Up until recently he has had adequate control of his blood glucose.
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He began with metformin, which was increased to 2000 mg daily; after 3 years he was started on glyburide, of which he now takes 20 mg per day. He has gained 11 lbs since beginning glyburide. Upon reviewing his detailed journal of blood glucose readings, you notice that while his fasting blood glucose is generally between 70 and 110 mg/dL, his post-prandial levels are no longer well-controlled. They are typically between 225 and 280 mg/dL. His A1c is 7.2%.
Because you are a skilled clinician, and you read the Diabetes in Control weekly newsletter, you know to begin your patient on a GLP-1 agonist. Upon asking your patient his thoughts on starting a new medication, he appears apprehensive. He has heard that many of these new medications for diabetes have very serious side effects that can even include heart attacks and cancer.
What side effects should you warn your patient about when starting them on a GLP-1 agonist? What do you tell them about the associated risks of these drugs?
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