Grupa: Użytkownik
Posty: 6 #8090477
Od: 2023-6-17
| Patients using them improve all parameters: glycemic, lipid, there is a reduction in body weight, blood pressure is lowered, liver function is also improved, and after some time also kidney function. When it comes to glycemic parameters, the power of GLP-1 analogues is very high, they reduce the level of HbA1c by 1.2-1.5%. For comparison: insulin lowers it by 1.5-2 percent, but its use may cause the risk of hypoglycemia and weight gain. In the case of GLP-1 analogues, there is no such risk. The comfort of patients' lives is also changing. In some patients, it becomes possible to discontinue insulin or reduce its doses and simplify the therapy regimen. Very often it turns out that it is no longer necessary to administer mealtime insulins, we leave the patient with only a smaller dose of basal insulin in 1 injection. With a decrease in body weight, glycemic control improves, and it is often possible to completely discontinue inulin. This is a huge change for patients. I have a patient of 20 years treated with four injections of insulin, when he started using semaglutide injection, he was able to stop it. Reduced body weight, no risk of hypoglycemia and a simple treatment regimen. For now, I do not have much experience with its use, because it has only recently been available. The effectiveness is high, which can be seen in clinical trials, comparable to semaglutide in subcutaneous form. GLP-1 analogues are highly positioned drugs in the recommendations of the Polish Diabetes Society: we should introduce them as soon as possible. Patients should use them already when they have been diagnosed with diabetes and cardiovascular risk factors, such as obesity, insulin resistance. Already after my first patients who use oral semaglutide, I can see that they have better glycemic control and reduce body weight. Generally, the higher the body weight ?we start?, the greater the weight loss. The patient notices that he is losing weight, this is important to him, he sees that the drug is effective. Yes. Especially in patients in the early stages of type 2 diabetes, the oral form of semaglutide may work well. This is important because diabetes is progressive and increases the risk of cardiovascular events 2-4 times. Many patients at the early stage of diabetes treatment who do not yet have complications, high obesity, and only cardiovascular risk factors would like to use such a drug. It would be easier for them to accept the fact that they receive oral medications: metformin, which is still recommended as a first-line drug, and oral semaglutide. Of course, over time, patients get used to injections and accept them, but in the early stages it is easier to persuade them to take a tablet than a subcutaneous injection. Although, of course, the patient must be made aware that the technique of taking the oral form of semaglutide is important, it should be taken on an empty stomach (also before other drugs), drink a glass of water and wait 30 minutes. Only then can you eat a meal and take other medications. Therefore, it is worth offering Rybelsus to patients at an early stage of the disease, when they do not yet have major complications and do not have to take many medications. The second group that would definitely benefit from this form of medicine are patients who travel frequently, especially by plane. Recently, I had to write a certificate for a patient that she was carrying a medicine in a pen, and it is not insulin. It seems a trifle, but for these patients it is burdensome when they have to explain the transported drugs. |
