Rothberg, MD, a clinical professor at the University of Michigan, specializing in treating overweight and obesity
obesity medicine physician, Massachusetts General Hospital, Boston, Mass
As patients lose weight and metabolic control improves, clinicians should reassess concurrent therapies to reduce the risk of hypoglycemia and polypharmacy, particularly when insulin or sulfonylureas are used
(They studied participants who did not have diabetes because the disease introduces more confounding variables.) The researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, perhaps because the unamidated form would be less stable
Clinicians should exercise caution in patients with a history of pancreatitis or gastroparesis, inflammatory bowel disease, other gut motility disorders, medullary thyroid carcinoma, or Multiple Endocrine Neoplasia syndrome type 2, and pause therapy when clinically indicated, such as before anesthesia
While primary care physicians are getting more comfortable prescribing these medications, we have a whole clinic built around it, Dr