Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-30

pain, pain radiating to the back, vomiting. Caution with a history of pancreatitis or pancreatic cancer • Not recommended in severe renal insufficiency, dialysis, hepatic insufficiency. • Use with other risk factors for pancreatitis (e.g. gallstones, alcoholism, hypertriglyceridemia). Considerations in the older adult • Assess the impact of GI symptoms. • Weight loss may not be appropriate in the frail or cachexic. FDA Black Box Warning : Risk of thyroid C-cell tumours based on preclinical rodent studies (liraglutide, albiglutide, dulaglutide, exenatide) (71). Contraindication • If eGFR <15 mL/min/1.73m 2 Each prefilled pen will deliver: • has markings to deliver 0.6 mg, 1.2mg or 1.8mg • Needle not included.

Liraglutide (Victoza ® ) Long-acting GLP-1 Analogue with 97% sequence homology (resemblance) to human GLP-1. • TDD: 0.6 mg-1.8 mg • Frequency: QD • Taken at any time. Dosing schedule • Initiate at 0.6 mg sc QD • Titrate to 1.2 mg sc QD after 1 week, if tolerating well. • May titrate to 1.8 mg sc QD in 1-2 weeks if tolerating well or minimal adverse effects.

Dose that has demonstrated cardiorenal benefits: • liraglutide 1.8mg sc QD