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These combined effects result in improved glycemic control and weight reduction

Clinical scenarios warranting consideration of GLP-1 therapy include: Type 2 diabetes management : Per ADA 2024 Standards of Care, GLP-1 RAs may be considered as initial therapy in patients with established atherosclerotic cardiovascular disease (ASCVD), high ASCVD risk, chronic kidney disease (CKD), or heart failure, or as add-on therapy when glycemic targets aren't met Established cardiovascular disease : Several GLP-1 receptor agonists have demonstrated cardiovascular risk reduction in patients with type 2 diabetes and established ASCVD Chronic kidney disease : While SGLT2 inhibitors are generally prioritized for CKD with type 2 diabetes when eGFR allows, GLP-1 RAs may provide complementary benefits Obesity with complications : When lifestyle interventions produce insufficient weight loss in patients with obesity-related comorbidities Important safety considerations include: Contraindications : Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2

Other safety considerations include: Common gastrointestinal side effects (nausea, vomiting, diarrhoea), which can affect absorption of oral medications, including levothyroxine [1] [7] Risk of pancreatitisseek urgent medical attention if you develop severe, persistent abdominal pain Gallbladder problems, including gallstones Potential worsening of diabetic retinopathy in people with type 2 diabetes If you experience severe or persistent side effects, contact your healthcare provider, as this may necessitate temporary dose adjustment or interruption of Wegovy

Gastrointestinal adverse events during follow-up were statistically significant (82)

A SGLT2i + DPP4i FDC is a suitable option for Indian T2D patients, for the following reasons: Safer, rapid, and sustained glycemic control Improves both insulin resistance and beta cell function Helps reduce body weight and blood pressure (extraglycemic benefits) Reduces pill burden (adherence and compliance improves) Overall cost effective The following decision-making algorithms (Fig