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Author: Admin | 2025-04-28
A plus. Patients on Januvia may experience edema, rash, and UTIs. Although the medication can be costly, coupons are widely available.8. Pioglitazone (thiazolidinediones)Pioglitazone works by increasing peripheral insulin sensitivity. It also has been shown to decrease A1C levels by 0.5% to 1.4%.3 Although pioglitazone has very good efficacy in terms of getting patients to target, it is not the best option for some because it can cause or exacerbate heart failure. Patients may experience nausea and stomach upset when taking this medication.9. Victoza (glucagon-like peptide 1 agonist)Victoza works by decreasing glucagon secretion, increasing glucose insulin secretion, and slowing gastric emptying. It is a daily injection given without regard to meals. This option has demonstrated significant weight loss in patients. Victoza has been shown to decrease A1C levels by 0.5% to 1.1% and reduce post- prandial blood glucose.3 Patients may experience nausea, which is the primary adverse effect that has been reported, but this is a well-tolerated injection.10. Trulicity (glucagon-like peptide 1 agonist)This option is relatively new and soon may be preferred over Victoza as it only needs to be injected once a week. It can be costly, however. The drug works in the same way as Victoza but requires fewer injections. Patients also will see weight loss with this medication, although it can cause pain and inflammation in the pancreas.REFERENCESFourlanos S, Perry C, Stein MS, Stankovich J, Harrison LC, Colman PG. A clinical screening tool identifies autoimmune diabetes in adults. Diabetes Care. 2006;29(5):970-975. doi:10.2337/diacare.295970National diabetes statistics report. CDC. Updated February 14, 2020. Accessed June 23, 2020. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html#:~:text=Total%3A%2034.2%20million%20people%20have,people%20(21.4%25%20 are%20undiagnosedIntroduction: standards of medical care in diabetes—–2019. Diabetes Care. 2019;42 (suppl 1):S1-S2. doi:10.2337/dc19-Sint01Handelsman Y, Bloomgarden ZT, Grunberger G, et al. American Association of Clinical Endocrinologists and American College of Endocrinology—–clinical practice guidelines for developing a diabetes mellitus comprehensive care plan––2015. Endocr Pract. 2015;21(suppl 1):1-87. doi:10.4158/EP15672.GL
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