Hayley is a 45 year old female who has been diagnosed with type 2 diabetes mellitus for 2 years....
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Her glycosylated hemoglobin (A1c) level is currently 7.9% with a regimen consisting of metformin 1000 mg twice daily, titrated from 500 mg twice daily 1 year ago at which time her A1c was 7.8%. Patient reports good adherence to both her drug regimen and recommended lifestyle modifications. Both you and Hayley are worried about weight gain as she has gained 9 kg since diagnosis, despite her best efforts. You decide to initiate a glucagon like peptide-1 (GLP-1) receptor agonist in addition to metformin.
Which are the main mechanisms of action of glucagon like peptide-1 (GLP-1) receptor agonists?
1. Inhibits dipeptidyl peptidase-4
2. Suppresses glucagon secretion
3. Slows gastric emptying
4. Blocks sodium glucose transporter in proximal tubule
5. Increases secretion of insulin in the presence of elevated glucose
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