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Important precautions and safety considerations include: Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (precaution per UK SmPC) Severe gastrointestinal disease History of pancreatitis (requires careful assessment) Diabetic retinopathy requiring close monitoring Risk of gallbladder disease (seek care for persistent upper abdominal pain, fever, jaundice) Dehydration and possible kidney injury with severe gastrointestinal symptoms (maintain hydration) Small mean heart rate increase noted in trials (consider monitoring in patients with cardiovascular disease) Reduced exposure to oral contraceptives (use barrier contraception for 4 weeks after initiation and dose increases) Avoid during pregnancy and breastfeeding unless clearly necessary When to seek urgent medical attention: Severe, persistent abdominal pain (potential pancreatitis) Signs of allergic reaction (rash, difficulty breathing, facial swelling) Persistent vomiting leading to dehydration Symptoms of hypoglycaemia if taking insulin or sulfonylureas concurrently Blood pressure 180/120 mmHg or if chest pain, severe breathlessness, neurological symptoms, or acute confusion develop Regular follow-up with healthcare professionals, typically every 36 months, allows for assessment of treatment response, adverse effects, and necessary adjustments to the overall treatment plan
Honestly, ignoring these is like trying to bake a cake by only paying attention to the oven temperature
Dosage and Titration: The starting dosage of dulaglutide for type 2 diabetes is 0.75mg per week
Its not clear that fasting levels of GLP-1 tell us anything useful because the intestine releases GLP-1 following a meal, and its that post-meal surgenot levels when you havent eatenthats beneficial for blunting appetite and helping the body clear blood sugar
It also suggests that monotreme GLP-1 peptides might promote unique, as yet unknown functions through the montreme GLP-1Rs
The remaining 20% comes gradually over the following months
