According to NICE guideline NG28, GLP-1 receptor agonists should be considered when: Triple therapy (metformin and two other oral drugs) is not effective, not tolerated, or contraindicated The patient has a BMI 35 kg/m (or lower in people of Black, Asian and other minority ethnic groups) and specific obesity-related comorbidities The patient has a BMI 40% reduction in non-HDL cholesterol GLP-1 receptor agonist for glycaemic control and weight management (with secondary lipid benefits) Ezetimibe if non-HDL cholesterol reduction is insufficient Lifestyle interventions addressing diet, exercise, and weight Monitoring and follow-up are essential components of cholesterol management
The authors suggest that the negative effect of metformin on exercise results from metformin lowering ROS levels, thus reducing the effects of ROS to activate AMPK
Hyperpigmentation Dark spots or discolorations, often a result of acne, sun damage, or hormonal changes, may be corrected with Tretinoin
Psychopharmacology (Berl.) 191, 567578