Rovo, P
Shreya Sangam, Pharm D, PhD, Post Doc, Boston University for scientific advice, and Saveetha College of Pharmacy, SIMATS for supporting research
While GLP-1s are excellent at stabilizing blood sugar, they can, in rare cases (especially when combined with other diabetes medications), cause hypoglycemia (low blood sugar)
Alternative medication classes should be considered if GLP-1 therapy proves intolerable: SGLT2 inhibitors (such as dapagliflozin, empagliflozin) for type 2 diabetes, which work via a completely different mechanism and rarely cause gastrointestinal side effects DPP-4 inhibitors (such as sitagliptin, linagliptin), which enhance endogenous GLP-1 activity more gently Metformin remains first-line for type 2 diabetes, though it can also cause gastrointestinal side effects Orlistat for weight management, though this also has gastrointestinal side effects of a different nature For weight management specifically, NICE recommends a comprehensive approach including dietary modification, increased physical activity, and behavioural interventions, with or without pharmacotherapy