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As we age, NAD+ levels naturally decline, which may contribute to lower energy levels, decreased mental sharpness, and other signs of aging

Dhyani P, Quispe C, Sharma E, Bahukhandi A, Sati P, Attri DC, Szopa A, Sharifi-Rad J, Docea AO, Mardare I, et al

Combining with DPP-4 inhibitors is generally not recommended, as both drug classes work on the incretin system Adding basal insulin for those with more significant hyperglycaemia, which can be used alongside GLP-1 medications (with careful monitoring for hypoglycaemia) Switching to insulin therapy entirely may be necessary for those with advanced beta cell failure For weight management , when GLP-1 medications don't produce adequate weight loss, alternatives include: Orlistat , a lipase inhibitor that reduces fat absorption, though weight loss is typically modest (2-3 kg on average) Naltrexone-bupropion (Mysimba), which works on appetite centres through different pathways

Segn las guas de la American Diabetes Association (ADA), los agonistas del receptor GLP-1 con beneficio cardiovascular demostrado se recomiendan para pacientes con diabetes tipo 2 que tienen enfermedad cardiovascular aterosclertica o alto riesgo cardiovascular, independientemente del uso de metformina

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