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Besides its glucose-lowering effect, GLP-1 has other extra-pancreatic effects
Eat smaller, more frequent meals rather than large portions, avoid high-fat and greasy foods that delay gastric emptying further, eat slowly and mindfully to recognize satiety signals, stay well-hydrated with 8-10 glasses of water daily, and identify individual trigger foods through a food diary
Affordability and lack of insurance coverage were major obstacles in obtaining medications
Moreover, A double-blind study of patients with T2DM treated with metformin led to significant changes in the relative abundance of more than 80 bacterial species compared with placebo after 4 months, in which an increase in Escherichia and Akkermansia muciniphila and a decrease in Intestinibacter were also observed, whereas most of the changes with placebo occurred in phylum Firmicutes and phylum Proteobacteria (Wu et al., 2017)
The patience required during dose escalation is actually one of the most valuable aspects of the protocol
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