Many people assume these medications are beyond their reach, uncertain about coverage options
Their weight loss and antihyperglycemic benefits have been confirmed [43,44]
These typically improve over time
NICE guidelines (NG28) support their use in specific clinical scenarios, particularly for patients with a BMI 30 kg/m (or 27 kg/m in certain ethnic groups) when HbA1c targets are not met or when weight reduction would provide significant health benefits
For example, GLP-1RAs may modulate the CD36-JNK-AP1 pathway by partially down-regulating prolyl 4-hydroxylase subunit alpha-1 (P4HA1), and then inhibit ROS production mediated by Ang II type I receptor, thereby ameliorating cardiac fibroblast proliferation and myocardial fibrosis [167, 168]
Clinical trials of 48 weeks duration showed acceptable safety profiles