This week we examine more of your responses regarding GLP-1 therapy....
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I was glad to see that almost everyone realized that when a GLP-1 agonist is added to a sulfonylurea that it is not the GLP-1 agonist that is responsible for any side effects. It's important to let your patients know as they will often blame the last medicine given on any negative effects. Many thought leaders recommend either decreasing or eliminating the sulfonylurea at the initiation of a GLP-1 agonist.
There is no doubt that if a patient on a GLP-1 agonist ingests alcohol without eating, this can cause hypoglycemia. As you can see above, our readers were in agreement.
Everyone was very positive that there is an increased but very rare risk of pancreatitis vs. the general population but there seemed to be a lot of confusion as to whether DPP-4 inhibitors can do the same thing. Only physicians were confident that DPP-4 inhibitors can cause rare cases of pancreatitis.
I was surprised to see that many of the respondents felt that GLP-1 agonists are excreted unchanged, as the mechanism of action of DPP-4 inhibitors is to prevent DPP-4 from breaking down GLP-1 after it is released
Almost everyone knew that Byetta was to be taken 60 minutes before meals and as you can see above you were all very much aware that if you miss a dose of Byetta then you should not try to make it up.
In contrast to the requirement that Byetta be taken 60 minutes before meals, your colleagues know that Victoza can be taken without regards to meals and only one time a day.
Analysis by Dave Joffe, Editor-in-chief
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