NHS Wegovy is available through specialist weight management services for eligible patients but faces severe supply constraints and waiting lists extending months to years in many areas
Gut Microbes 14 , 2031840 (2022)
10% excreted unchanged by the kidney contraindicated: hepatic dysfunction renal insufficiency 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 Metformin: (Glucophage) 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 most common -- gastrointestinal (20% frequency) anorexia, nausea, vomiting, diarrhea dose-related usually occurs upon initiation of therapy -- often transient in effect Decreased vitamin B 12 absorption
2024 endocrine and obesity reviews reiterate the dual GIP/GLP-1 signalling profile without redefining it [2]
While in liver diseases a down regulation of PPAR is observed, the authors could show that an FXR ligand protects against that mechanism and also that the FXR ligand improves the antifibrotic activity of PPAR ligands
He expects those strong sales will continue in 2024, "we're guiding for 18 to 26% growth"
