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Recent clinical studies reported that SGLT-2is improved hypertension and atrial fibrillation by modulating the overstimulated renin-angiotensin-aldosterone system (RAAS) and suppressing the sympathetic nervous system (SNS) by directly/indirectly acting on the rostral ventrolateral medulla
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The neurologic side effects include confusion, dizziness, drowsiness, slurred speech, balancing issue, loss of consciousness, muscular paralysis, fatigue, numbness, tingling, and/or burning
Ultimately, the choice of GLP-1 medication should be individualised, considering efficacy, dosing convenience, cost, UK licensing, and the patient's previous experience with gastrointestinal symptoms
Start at 0.25 mg for four weeks, then increase monthly through 0.5, 1.0, 1.7, and 2.4 mg
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