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Injectables For Diabetes

Type 2 Diabetes Non-insulin Injectable Medications

Type 2 Diabetes Non-insulin Injectable Medications

If the oral diabetes medication you're taking isn't getting your HbA1c into a healthy range, your doctor may suggest a combination therapy that also includes injectable insulin or an injectable medication. Which medications you wind up using depends on your preference and medical history. The goal for medication therapy of type 2 diabetes is generally an HbA1c of less than 7%.1 However, your health care provider will determine your HbA1c goal based on individual factors. GLP-1 Receptor Agonists How they work: Increase insulin production, decrease sugar made in the liver, decrease food intake. Names: exenatide (Byetta); liraglutide (Victoza); dulaglutide (Trulicity); albiglutide (Tanzeum). Benefits: Helps with weight loss. Decreases some cardiovascular risk factors. Helps slow the rise in blood glucose levels after a meal. Infrequent dosing. Possible side effects: gastrointestinal symptoms (vomiting, diarrhea); increased heart rate. Notes: once-a-week dosing now available. Contraindicated in people with ketoacidosis or severe kidney problems. Amlyin Mimetics How they work: reduce glucagon levels which helps to reduce blood glucose levels. Name: pramlintide (Symlin) Benefits: helps with weight loss, helps slow the rise in blood glucose levels after a meal. Possible side effects: modest efficacy; gastrointestinal symptoms (nausea, vomting); hypoglycemia. Notes: injected before you eat. Frequent dosing schedule and training requirements considered a drawback. Welcome to the Type 2 Diabetes Center! This is your launching pad for living better with type 2 diabetes. We’ve gathered all the latest type 2 diabetes information, research updates, and advances in devices and medications. And because diabetes impacts every facet of your life, you’ll also find practical advice fro Continue reading >>

For Adults With Type 2 Diabetes

For Adults With Type 2 Diabetes

What is the most important information I should know about Victoza®? Victoza® may cause serious side effects, including: Possible thyroid tumors, including cancer. Tell your health care provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rats and mice, Victoza® and medicines that work like Victoza® caused thyroid tumors, including thyroid cancer. It is not known if Victoza® will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. Who should not use Victoza®? Do not use Victoza® if: you or any of your family have ever had MTC or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). you are allergic to liraglutide or any of the ingredients in Victoza®. What should I tell my health care provider before using Victoza®? Before using Victoza®, tell your health care provider if you: have or have had problems with your pancreas, kidneys, or liver. have any other medical conditions or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food. are pregnant or breastfeeding or plan to become pregnant or breastfeed. Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and other medicines to treat diabetes, including insulin or sulfonylureas. How should I use Victoza®? Do not mix insulin and Victoza® together in the same injection. You may give an injection of Victoza® and insulin in the same body area (such as your stomach area), but not right next to each other. Do not share your Victoza® pen with ot Continue reading >>

Who Is The Best Candidate For Non-insulin Injectables?

Who Is The Best Candidate For Non-insulin Injectables?

Who is the Best Candidate for Non-Insulin Injectables? Who is the Best Candidate for Non-Insulin Injectables? The number of diabetes cases is growing, but so are therapeutic options for treating this life-long illness. Physicians can now present patients with a much broader range of treatment choices that can be tailored to their needs. Over the last 10 years, non-insulin injectable drugs have been shown to be effective therapeutic options in the continuum of diabetes care. As a physician, Ive seen many of my diabetes patients improve significantly using this class of drugs. Non-insulin injectable is a generic term that encompasses any medication injected to treat diabetes aside from insulin. The term typically refers to a group of six drugs; five belong in the glucagon-like peptide 1 (GLP-1) receptor agonist class, and another is considered an amylin analog. These seven medications have been approved by the U.S. Food and Drug Administration (FDA) to treat diabetes. The GLP-1 drugs mimic the bodys native hormone that tells the brain to prepare for the arrival of food and to stop eating when full. The GLP-1 class also helps stimulate insulin production, needed to regulate your blood sugar level, decrease production of glucagon, the hormone which asks the liver to produce more of your own sugar, and store energy from the food you eat. Currently, the FDA has approved the following GLP-1 drugs for diabetes: exenatide (Byetta), exenatide extended release (Bydureon), albiglutide (Tanzeum), dulaglutide (Trulicity), and liraglutide (Victoza). Managing diabetes goes beyond focusing on blood sugar levelsyouve got to commit to living a healthy life, staying active, eating well, and minimizing stress. Follow these tips to get on the right path. Medical Reviewer: William C. Lloyd I Continue reading >>

Table Of Medications

Table Of Medications

Medications used to treat type 2 diabetes include: Use this table to look up the different medications that can be used to treat type 2 diabetes. Use the links below to find medications within the table quickly, or click the name of the drug to link to expanded information about the drug. Table of oral medications, incretion-based therapy and amylin analog therapy: Medicine FDA Approval Formulations (color indicated if available by Brand only) Dosing Comments (SE = possible side effects) STIMULATORS OF INSULIN RELEASE (Insulin Secretagogues) – increase insulin secretion from the pancreas1 SULFONYLUREAS (SFUs) Tolbutamide Orinase® various generics 1957 500 mg tablets Initial: 1000-2000 mg daily Range: 250-3000 mg (seldom need >2000 mg/day) Dose: Taken two or three times daily SE: hypoglycemia, weight gain Preferred SFU for elderly Must be taken 2-3 times daily Glimepiride Amaryl® various generics 11/95 1 mg, 2 mg, 4 mg tablets Initial: 1-2 mg daily Range: 1-8 mg Dose: Taken once daily SE: hypoglycemia, weight gain Need to take only once daily Glipizide Glucotrol® Glucotrol XL® various generics 5/84 4/94 5 mg, 10 mg tablets ER: 2.5 mg, 5 mg, 10 mg tablets Initial: 5 mg daily Range: 2.5-40 mg2 (20 mg for XL) Dose: Taken once or twice (if >15 mg) daily SE: hypoglycemia, weight gain Preferred SFU for elderly ER = extended release/take once a day Glyburide Micronase®, DiaBeta® various generics 5/84 1.25 mg, 2.5 mg, 5 mg tablets Initial: 2.5-5 mg daily Range: 1.25-20 mg2 Dose: Taken once or twice daily SE: hypoglycemia, weight gain Glyburide, micronized Glynase PresTab® various generics 3/92 1.5 mg, 3 mg, 4.5 mg, 6 mg micronized tablets Initial: 1.5-3 mg daily Range: 0.75-12 mg Dose: Taken once or twice (if >6 mg) daily SE: hypoglycemia, weight gain GLINIDES Repaglini Continue reading >>

Diabetes Drugs You Inject That Aren't Insulin

Diabetes Drugs You Inject That Aren't Insulin

Insulin isn't the only type of injectable diabetes medicine your doctor might prescribe for you. Other drugs include: Albiglutide (Tanzeum) What it is: It's a man-made version of a hormone called GLP-1 (glucagon-like peptide-1). Your intestines normally release this substance when you eat. It helps control your blood sugar. Who can take it: Adults who have type 2 diabetes and haven’t had success with other treatment. If you're planning to get pregnant, talk with your doctor, since researchers haven't studied albiglutide in pregnant women. What it does: After you eat, albiglutide helps your pancreas release insulin, which moves blood sugar (glucose) into your cells. It also limits how much of the hormone glucagon your body makes. This substance spurs your liver to release stored sugar. The drug also slows down digestion. Side effects: The most common ones are upper respiratory tract infection, diarrhea, nausea, and skin reactions where you give yourself the shot. All GLP-1 drugs, including albiglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don't know whether it has the same effect in people, though. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect. Exenatide (Bydureon, Byetta) What it is: Exenatide was the first GLP-1 drug approved by the FDA. Byetta came first. You take it as a shot twice daily. Bydureon is the newer, extended-release version, which you inject once a week. You can't take both drugs. Who can take it: Adults with type 2 diabetes for whom other treatment hasn't worked. If you think you might get pregnant, talk to your doctor. Researchers haven't studied this drug in pregnant women. What it does: Like other GLP-1 drugs, Continue reading >>

Oral And Injectable (non-insulin) Pharmacological Agents For Type 2 Diabetes

Oral And Injectable (non-insulin) Pharmacological Agents For Type 2 Diabetes

Go to: ABSTRACT Diabetes has reached epidemic proportions throughout the world and will continue to grow and remain the greatest global health challenge the world has ever known: 415 million people have diabetes (1 in 11 adults), and the number of people with the disease is predicted to rise beyond 642 million (55%; 1 in 10 adults) in less than 25 years. Individuals with type 1 and type 2 diabetes are at a significantly greater risk for developing microvascular and macrovascular diseases. In response to the enormity of the growing problem, efforts to identify and develop new pharmacological agents for type 2 diabetes have increased dramatically over the past 25 years. Currently in the US and most other world areas, there are nine classes of orally available pharmacological agents to treat type 2 diabetes: 1) sulfonylureas, 2) meglitinides, 3) metformin (a biguanide), 4) thiazolidinediones, 5) α-glucosidase inhibitors, 6) dipeptidyl peptidase IV (DPP-IV) inhibitors, 7) bile acid sequestrant, 8) dopamine agonist, and 9) sodium-glucose transport protein (SGLT2) inhibitors. A variety of fixed combination of 2 agents are also available. Besides the many options for insulin, there are also two classes of injectable medications: glucagon like peptide-1 (GLP-1) receptor agonists (incretin mimetics) and an amylin analogue. This chapter provides an overview and description of the existing oral and injectable (non-insulin) pharmacological agents for type 2 diabetes along with an up-to-date listing of those agents currently in early and late-stage clinical development. Go to: INTRODUCTION Diabetes has reached epidemic proportions throughout the world and will continue to grow and remain the greatest global health challenge the world has ever known: 415 million people have diabetes Continue reading >>

Non-insulin Injectable Diabetes Medications

Non-insulin Injectable Diabetes Medications

As you’ve learned over the past few months, there are numerous types of diabetes pills that can be effective in treating Type 2 diabetes. But, thanks to the changing nature of this condition, over time, diabetes pills may not be enough to keep blood sugars and HbA1c within a safe range. In the past, the next step would be to start on insulin. And while many people do, indeed, go on insulin (and there’s nothing wrong with that), today, there are other options: these are the non-insulin injectable medications. Amylin analog Amylin is a hormone that is secreted along with insulin in response to food intake. In people with Type 1 diabetes and people with Type 2 diabetes who require insulin, both insulin and amylin is reduced due to the beta cells in the pancreas not working as they should. The first non-insulin injectable drug for diabetes was approved by the FDA in 2005 — this drug was pramlintide (brand name Symlin), a synthetic form of amylin. How it works: Pramlintide slows gastric emptying, blocks the release of glucagon (a hormone that raises blood sugar), reduces after-meal glucose release from the liver, and helps to reduce food intake, possibly leading to weight loss. The result? Less of a rise in blood sugars after eating a meal. Who it’s for: Pramlintide is only used in people with diabetes who take insulin. People with Type 2 diabetes can take this medication if they also take mealtime, or fast-acting, insulin. How it’s taken: This drug must be injected before each major meal. It can’t be mixed with insulin, so it means taking more injections. Dosing is started low and gradually increased, as needed. Mealtime insulin doses usually need to be decreased to reduce the risk of low blood sugar. Pramlintide is available in a pen (much like an insulin pen). Continue reading >>

Diabetes: Non-insulin Injectable Medications

Diabetes: Non-insulin Injectable Medications

What are some non-insulin injectable drugs to treat diabetes, and how do they work? How it works: Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver. Comments/special instructions: Byetta® is taken twice a day, within one hour before the two largest meals of the day. Byetta® can be used in combination with a sulfonylurea, metformin, thiazolidinediones, or Lantus. Byetta® helps with weight loss. The risk of hypoglycemia (low blood sugar) is greater if Byetta® is used with insulin or a sulfonylurea. Byetta® should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Exenatide Extended Release (Bydureon®) Bydureon is an extended-release form of exenatide and is injected once every seven days. Bydureon® cannot be used when taking Byetta. Bydureon® can be used in combination with a sulfonylurea, metformin, or thiazolidienediones. The risk of hypoglycemia is greater if Bydureon® is used with sulfonylurea. Bydureon® should not be used in combination with insulin. Bydureon should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). How it works: Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver. Comments/special instructions: Victoza® is taken once a day at any time, regardless of meal times. Victoza® can be used in combination with sulfonylureas, metformin, or thiazolidinediones. Victoza® helps with weight loss. The risk of hypoglycemia is greater if Victoza® is used with insulin or a sulfonylurea. Vict Continue reading >>

The Pros And Cons Of Non-insulin Injections For Diabetes

The Pros And Cons Of Non-insulin Injections For Diabetes

If you have type 2 diabetes that’s not adequately controlled with diet and lifestyle changes, your health care provider is likely to start you on a single oral medicine such as metformin. However, it’s not uncommon for you to require additional therapy to reach your diabetes goals. Non-insulin injectables are an option for your diabetes management as an add-on therapy either before or after insulin treatment. Advances in diabetes treatment have recently brought us non-insulin injectable medications, which can be a great option to help you control your diabetes and stay healthy. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. Available Non-Insulin Injections for Diabetes There are a number of different injectables currently available for diabetes, including: GLP-1 (glucagon-like peptide-1) agonists like Byetta and Bydureon (exenatide), Victoza (liraglutide), Tanzeum (albiglutide), Trulicity (dulaglutide), and Adlyxin (lisixenatide): this medication class helps the pancreas release insulin after a meal, blocks a hormone called glucagon that increases blood sugar levels, and slows down digestion, which helps you feel fuller, faster. While there are no comparative trials of long-term outcomes with this class of drugs, one study indicates patients with a prior history of stroke or heart attack may benefit from treatment with liraglutide. Pramlintide: This synthetic hormone is similar to a natural hormone called amylin that is produced by the pancreas with insulin. It blocks the release of glucagon, decreases post-meal blood sugar levels and slows the passage of food from the stomach, which p Continue reading >>

New Injectables For Diabetes: Shots That Aren’t Insulin Are Becoming Popular Among Diabetics

New Injectables For Diabetes: Shots That Aren’t Insulin Are Becoming Popular Among Diabetics

No, it’s not insulin. New injections for diabetes may change the way we manage adult-onset diabetes. Approval of a new once-a-week injection called Bydureon is an exciting new option for blood sugar control. This new class of injectables may be popular for several reasons, not the least of which is they also result in weight loss. Yippee! Though it sounds straight out of outer space, these drugs are called incretin mimetics, meaning they mimic the incretin hormones that tell your body to release insulin after eating. These drugs work in very cool ways by enhancing insulin secretion, slowing stomach emptying, reducing food intake, and promoting proliferation of β-cells (cells that make insulin). Byetta (exenatide) was the first in this class and is used to improve blood sugar control in adults with type 2 diabetes. The most interesting part is that exenatide is an amino acid isolated from the salivary gland venom of the Gila monster. There are now three choices in this class: Byetta, Victoza and the newly approved Bydureon. All three may be used with other oral diabetes medicines. All three are used to treat adult onset diabetes and all three result in weight loss, a nice bonus. So how are Byetta, Victoza and the new Bydureon different? Byetta (exenatide) is injected twice a day before your morning and evening meal. Victoza (liraglutide) is given once a day instead of twice a day (like Byetta). The just-approved Bydureon is an extended release form Byetta (exenatide). Bydureon is attractive because it is a once-weekly injection. While all of them may cause some nausea/vomiting, this is higher with Byetta and was the most common adverse event associated with Byetta. The nausea/vomiting decreases in frequency and severity over time. Reports of pancreatitis have dogged a Continue reading >>

Insulin And Non-insulin Injectable Diabetes Medications: Practical Information For Pharmacists

Insulin And Non-insulin Injectable Diabetes Medications: Practical Information For Pharmacists

Insulin and Non-Insulin Injectable Diabetes Medications: Practical Information for Pharmacists At some point in your career, youve probably encountered questions from patients or health care team members about diabetes medications stability and how the products are supplied. The following tables are intended to serve as practical guides, providing information on the various insulin vials (Table 1), insulin pens (Table 2), and non-insulin injectables (Table 3) currently available on the market. Please read individual package inserts for more details and updates as they occur. Erin Pauling, PharmD, is a clinical assistant professor of ambulatory care at Binghamton University School of Pharmacy and Pharmaceutical Sciences. She received her PharmD from the Bernard J. Dunn School of Pharmacy at Shenandoah University. She completed a PGY1 community pharmacy residency with Appalachian College of Pharmacy and a PGY2 ambulatory care residency with Wingate University School of Pharmacy. Her professional interests include anticoagulation, diabetes, immunizations and travel medicine. Pharmacy Times is the #1 full-service pharmacy media resource in the industry. Founded in 1897, Pharmacy Times reaches a network of over 1.3 million retail pharmacists. Through our print, digital and live events channels, Pharmacy Times provides clinically based, practical and timely information for the practicing pharmacist. Features and specialized departments cover medication errors, drug interactions, patient education, pharmacy technology, disease state management, patient counseling, product news, pharmacy law and health-system pharmacy. Pharmacy Times Continuing Education (PTCE) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy educati Continue reading >>

Byetta, Victoza, Bydureon: Diabetes Drugs And Weight Loss

Byetta, Victoza, Bydureon: Diabetes Drugs And Weight Loss

Tell me about the diabetes drugs Byetta, Victoza and Bydureon. Can they really help people who have diabetes lose weight? Are there side effects? Answers from M. Regina Castro, M.D. Exenatide (Byetta, Bydureon) and liraglutide (Victoza) are taken by injection, similar to insulin, but they're not insulin. These medications are in a class of drugs called incretin mimetics, which improve blood sugar control by mimicking the action of a hormone called glucagon-like peptide 1 (GLP-1). Among other things, these drugs stimulate insulin secretion in response to rising blood sugar levels after a meal, which results in lowering of the blood sugar. Byetta, Bydureon and Victoza not only improve blood sugar control, but may also lead to weight loss. There are many proposed ways in which these medications cause weight loss. They appear to help suppress appetite. But the most prominent effect of these drugs is that they delay the movement of food from the stomach into the small intestine. As a result, you may feel "full" faster and longer, so you eat less. Byetta is injected twice daily, and Victoza is injected once a day. Bydureon, a newer formulation, is injected once a week. These drugs do have different effects and side effects to consider. Exenatide (Byetta, Bydureon). The most common side effect of exenatide is mild to moderate nausea, which improves with time in most people. Several cases of kidney problems, including kidney failure, have been reported in people who have taken exenatide. Rarely, exenatide may cause harmful inflammation of the pancreas (pancreatitis). Liraglutide (Victoza). Some studies have found that liraglutide reduces systolic blood pressure and triglycerides, in addition to improving blood sugar control. The most common side effects are headache, nausea and Continue reading >>

Type 2 Diabetes Medicines You Inject

Type 2 Diabetes Medicines You Inject

By the dLife Editors Click on the name of the drug for information. Reviewed by James A. Bennett, RPh, FACA, CDE, 10/16. 1. Bydureon What is Bydureon? Bydureon is a member of the GLP-1 receptor agonist* family of medicines. Bydureon works in several places in the body, and addresses four different problems that may occur in people with diabetes. It works by supporting a system of hormones in the gut called the incretin system. These gut hormones are able to detect rises in blood sugar due to food intake, and they go to work telling the pancreas to release insulin. At the same time, they tell the liver not to release stored glucose. They act sort of like a thermostat: when blood sugar goes up, they turn up the insulin, and when it goes down, they turn down the insulin. In a person with type 2 diabetes, this incretin system does not function properly, and needs some help. Bydureon has the following actions in the body: Stimulates the pancreas to produce insulin when blood sugar goes up due to food intake. Keeps the pancreas from telling the liver to release stored glucose after a meal when it is not needed. Slows stomach-emptying time. Type 2 diabetes seems to make food clear the stomach more quickly than normal, which, in turn, causes a rapid spike in blood sugar. This rapid spike is hard for the body to handle, but a slower entry of sugar into the system is easier to handle. Stimulates the satiety center in the brain. The satiety center (the I’ve had enough to eat center in the brain) tells you that you are ready to push away from your plate of food. Causes weight loss. Many people will lose weight when they take these medicines, and that usually translates to better blood sugar control. Who can take Bydureon? Selected adults with type 2 diabetes can take Bydureon. Yo Continue reading >>

A Complete List Of Diabetes Medications

A Complete List Of Diabetes Medications

Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>

Two New Combination Injectable Drugs For Type 2 Diabetes Coming To Market

Two New Combination Injectable Drugs For Type 2 Diabetes Coming To Market

This feature requires the newest version of Flash. You can download it here . The US Food and Drug Administration (FDA) has approved two new combination injectable drugs that should be coming out on the market in the next few months. Both are combinations of insulin plus a GLP-1 receptor agonist. One is a combination of glargine and lixisenatide, which I am going to call LixiLan. The other is a combination of degludec and liraglutide, which I am going to call IDegLira. Those were the names that were used in the research studies for these two agents.[ 1 , 2 , 3 , 4 , 5 ] This may seem confusing, but the theory behind this is that type 2 diabetes is a disease of both insulin deficiency and insulin resistanceand a whole host of other issues. There is abnormal signaling in the gut and in the brain. Beta cells are not secreting normally. Glucagon levels are too high. We know about the ominous octet. Many issues are involved in the pathogenesis of type 2 diabetes. We know that giving insulin works, but we are not treating all of those issues. Giving a GLP-1 receptor agonist can be very helpful, but for patients with significant insulin deficiency, that might not be enough. In the clinical trials[ 1 , 2 , 3 , 4 , 5 ] where they combined the GLP-1 receptor agonist with a long-acting insulin and dosed it up slowly like they were dosing up basal insulin, they got very good reductions in A1c levels. Some of the trials saw the biggest A1c reductions that I have seen with a diabetes drug. They also got fewer gastrointestinal side effects and fewer side effects in general, because you are going up very slowly on these agents, so patients seemed to tolerate them fairly well. Many patients tolerate a slower titration better than a rapid one. These two drugs will come out in different Continue reading >>

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