glp-1 weight management Loss Treatment: Find Your Best Match Promote your body’s GLP GLP-1 Weight Loss Specialist in

10% excreted unchanged by the kidney hepatic dysfunction Glimepiride: (Amaryl) monotherapy -- once a day administration or in combination with insulin most potent -- lowest dose of the sulfonylureas long duration of action: half-life = 5 hours hepatic metabolism: complete to inactive products Secondary Failure and Tachyphylaxis to Sulfonylureas: Treatment failures occur Possibly due to pancreatic B cell refractoriness or to loss of dietary compliance Combination of sulfonylureas and insulin would appear justified only in the presence of severe insulin resistance Biguanides Metformin: (Glucophage) Proposed Mechanism of Action: glycolysis stimulation-- increased glucose removal from blood decreased hepatic gluconeogenesis decreased glucose absorption rate from the GI tract reduced plasma glucagon in patients with refractory obesity and insulin resistance Advantages: does not cause hypoglycemia does not increased weight May be used in combination with sulfonylureas when sulfonylurea monotherapy is not effective Toxic/adverse effects: most common -- gastrointestinal (20% frequency) anorexia, nausea, vomiting, diarrhea dose-related usually occurs upon initiation of therapy -- often transient in effect Decreased vitamin B12 absorption

Tuna, beef and dairy are high in selenium, while vegan diets can be high in alpha-lipoic acid found in spinach, tomatoes and peas

1,2 Nearly 1 million individuals in the United States have PD, with about 90,000 new cases diagnosed every year

Subsequent large analyses did not confirm a significant increase in pancreatitis incidence due to GLP-1 RAs ( [64] ) ( [107] ), although a small elevation in risk cant be entirely ruled out (this is discussed under Safety)

Vlez JL, Zacharias N, Rakheja D, Bhagat TD, Lee J, Dutta P, Gonzalez D, Andreeff M , Bhattacharya PK, Verma A, Konopleva M