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Should metformin dose be increased first in a patient with type 2 diabetes mellitus, HbA1c 5.8%, taking metformin 500 mg daily, phentermine, and NP thyroid 60 mg daily, with poor diet and exercise compliance, before considering GLP-1 receptor agonists?

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Additionally, the potential influence of the IRA, under which Medicare will negotiate drug prices starting in 2027, adds further uncertainty to the future pricing of GLP-1RAs

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