McGraw-Hill / Lange rxlist.com (Trulicity ) Semaglutide Drug Names : Ozempic (for T2DM) - injectable Wegovy (for weight management) - injectable Rybelsus (oral) - 1st oral GLP-1 agonist (FDA approved 9/20/19) Drug Category : GLP-1 receptor agonist, hypoglycemic Synthetic peptide analog of GLP-1 Mechanism of Action: Synthetic peptide that is chemically identical to GLP-1, except for three amino acid substitutions and modifications at positions 8, 26 & 34 (Figure 1) that prevent chemical breakdown by DPP-4, and increase binding to albumin
GLP-1: appetite and gastric emptying GLP-1 signaling is strongly associated with reduced appetite, increased satiety, and slower gastric emptying
Other risk factors that may increase vulnerability include: Long duration of diabetes (typically more than 10 years) Poor glycaemic control prior to starting GLP-1 therapy (HbA1c significantly above target) Rapid reduction in HbA1c (a drop of more than 2 percentage points [22 mmol/mol] within 36 months) Concurrent hypertension , especially if poorly controlled Diabetic kidney disease (nephropathy), which often correlates with retinopathy severity Previous history of retinal treatment (laser photocoagulation or intravitreal injections) People with type 2 diabetes but no retinopathy appear to have minimal risk of retinopathy progression based on current evidence
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