When making a choice amongst GLP-1 Agonists, the number of injections per day and when peak concentrations are reached are both important in selecting therapy. There was almost unanimous consensus that Exenatide is administered twice daily while Liraglutide is given only one time a day. It was interesting to note that....
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most of the respondents indicated correctly that Byetta has a peak 2 hours after administration, however, the vast majority of medical professionals across the board felt that there was no peak to Victoza when this medication actually peaks at 8-12 hours.
Often times we think metformin is always the first choice as a medication for type 2 diabetes and this is shown when we asked about the use of GLP-1 Agonists as first line therapy. The overwhelming response to this question was "no." However, according to AACE guidelines, the use of a GLP-1 Agonist as a first choice is indicated and accepted especially in overweight or obese patients.
When it came to advising patients on how to store and prepare their GLP-1 Agonist for use there was a misconception that the pens could be stored at room temperature. Although once a pen is open it can be kept at a temperature below 80 degrees it is advised that the pens be refrigerated. This is especially important when a 3 pack of Victoza is dispensed.
More attention needs to be given to the proper priming method. Although nurses and pharmacists were mostly aware that the pens need to be primed only upon first use, there was also an overwhelming misconception that the GLP-1 Agonist pen devices must be primed every needle change, like insulin. Over 30% of nurse practitioners, 40% of physicians, and 50% of dietitians indicated that the pens needed to be primed before each use. This could explain why patients often run out of their GLP-1 agonist early.
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