Route and practicality matter
The mechanism is additive to statins [5], which lower LDL-C partly by upregulating LDL receptor expression but also increase PCSK9 levels as a compensatory response
The similar viewpoints were also supported by other critical reviews and clinical trials (58), and inferred that GLP-1RA could be considered in patients at a high risk of, or with established cardiovascular diseases to improve the prognosis of cardiovascular events (especially nonfatal stroke), whilst SGLT2i could be recommended for patients with heart failure or chronic kidney diseases
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Metformin is another popular and effective option, and according to the American Diabetes Association, DPP-4 inhibitors, SGLT2 inhibitors, sulfonylureas, and thiazolidinediones are other viable alternatives
Their primary mechanisms of action include: Stimulating insulin secretion in a glucose-dependent manner (reducing hypoglycaemia risk) Suppressing glucagon release when blood glucose is elevated Slowing gastric emptying, which prolongs satiety Acting on appetite centres in the brain to reduce food intake Common GLP-1 medicines available in the UK include semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity)
