maintenance on semaglutide Weight after discontinuation of GLP-1 therapies Starting maintenance dose, any advice?

HCPLive / AJMC

Other Ingredients: Magnesium stearate and silica in a clear vegetable capsule

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the Creative Commons license is provided, and any changes are indicated

Reduced Hepatic Steatosis: Fatty liver disease improves as both liver fat and systemic insulin resistance decrease

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

It is also a strong choice if you have insulin resistance, prediabetes, or metabolic syndrome