( Figure 5 ) Briefly, SGLT2i inhibits the SGLT receptors in the proximal tubule, which inhibits the reabsorption of glucose from primary urine, resulting in glycosuria and a decrease in HbA1c and fasting glucose levels ( Figure 5 Clinical implications Given the significant cardioprotective effect of SGLT2i and GLP-1RAs, the ADA guidelines state that all diabetic patients with confirmed or subclinical cardiovascular disease should be prescribed a GLP-1RA class or SGLT2i class with proven cardiovascular benefit, regardless of the patients HbA1c level or the presence of other glucose-lowering medications ( Strengths and limitations To the best of our knowledge, this is the first meta-analysis to assess the effects of SGLT2i and GLP-1RAs as first-line therapeutic agents in T2DM patients with low cardiovascular disease risk
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If you notice a site consistently causes more irritation than others, mention it at your next check-in, since some patients have body composition factors that make certain sites less ideal for them
Advanced timing optimization Once you have the basics dialed in, there are additional timing considerations that can further refine your protocol
Insurers are a major determinant of access, sometimes limiting use to specific diagnoses or patient populations
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