These medications are not recommended for people who are: Pregnant Have a personal or family history of medullary thyroid cancer Have a condition called multiple endocrine neoplasia type 2 Have had pancreatitis People with serious stomach conditions such as gastroparesis, those with advanced kidney disease and are prone to dehydration, and individuals with pre-existing diabetic eye disease should use these medications carefully and under close supervision by a healthcare provider
Of particular interest are GLP-1/GCG dual-receptor agonists, especially those targeting GLP-1, GIP, and GCG receptors simultaneously
Nevertheless, a conservative approach can be considered in patients who prefer not to progress to pharmacological therapy, provided that no major symptoms, such as hypoglycaemia leading to diminished awareness, coma or inability to drive or function, are present
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Early warning signs of hypoglycemia may be less obvious in patients with hypoglycemia unawareness which can be due to a long history of diabetes (where deficiencies in the release or response to counter regulatory hormones exist), with autonomic neuropathy, intensified diabetes control, or taking beta-blockers, guanethidine, or reserpine
