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Beta cell dysfunction – impaired insulin secretion
Alpha cell dysfunction – impaired glucagon secretion
Increased hepatic glucose output
Impaired incretin effect
Insulin resistance
Decreased glucose uptake by skeletal muscles
Increased glucose reabsorption
Neurotransmitter defects
7-8%
8.1-9%
9.1-10%
>10%
>7.5%
>8%
>8.5%
>9%
>9.5%
Advantage of cardiovascular outcomes –
Renal outcome benefits
Superior HbA1c control
Weight lowering
Overall safety
Tolerability
Ease of usage
< 5%
6-10%
11-15%
12-20%
>21%
6-20%
20-40%
40-50%
>50%
<5%
16-20%
NOT used so far
Early stages – I and II
Later stages – III and IV
Across stages – I to IV
<10%
10-25%
25-50%
5%
>15%
Not using GLP-1 currently
Yes
No
1-2
3-5
5-8
>10
1<5%
5-10%
High cost
Inconvenient to prepare
Taste issues – aftertaste etc
Multiple antidiabetic therapiesAny other suggestions