At Unified Endocrine & Diabetes Care , we see patients across Lafayette and throughout California , including via telemedicine for individuals in Silicon Valley, Palo Alto, Menlo Park, San Francisco, Walnut Creek, Oakland, and Sacramento
If you're on injection and still not responding, your prescribing clinician may consider a switch from semaglutide to tirzepatide or a dual-compound approach like GLP-Squared
It is listed on the PBS for patients who fulfil the following criteria: an eGFR of 25 mL/min/1.73 m 2 or greater an ACR of 22.6 mg/mmol or greater must be on a stable dose of either an ACE inhibitor or ARB must not have established HFrEF must be on an SGLT-2 inhibitor unless medically contraindicated or intolerant (refer to the full PBS clinical criteria at: Combination therapy Some evidence suggests that combination therapy with SGLT-2 inhibitors and mineralocorticoid receptor antagonists in patients with type 2 diabetes and CKD reduces the risk of CV events and the mineralocorticoid receptor antagonist-associated risk of hyperkalaemia without a significant interaction between the two drugs
SURMOUNT-1 reported up to 22.5% body weight loss at the 15 mg tirzepatide dose [2]
For further information on SGLT-2 inhibitors and DKA, see: When initiating dulaglutide (Table 5), reinforce lifestyle advice and offer support as required, and provide information on how to administer treatment (see below)
Eating bland foods, staying hydrated, and avoiding large meals around injection time helps prevent it
