Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-33

Semaglutide (Ozempic ® ) Long-acting GLP-1 Analogue with 94% sequence homology (resemblance) to human GLP-1. • TDD: 0.25 mg - 1.0 mg • Frequency: Once weekly • Taken same day of the week at any time with or without meals. • Missed dose: Taken if >48 hours until next scheduled dose. Dosing schedule • Initiate at 0.25 mg once weekly for 4 weeks. • Titrate to 0.5 mg once weekly for 4 weeks. • Titrate to 1.0 mg once weekly if not at target glycemic parameters. Exenatide extended-release (ER) (Bydureon)® Long-acting GLP-1 Analogue with 53% homology (resemblance) to human GLP-1. • TDD: 2 mg • Frequency: Once weekly • Taken same day of the week at any time, with or without meal. • Missed dose: taken if >48 hours until next scheduled dose. Dosing schedule • Initiate at 2 mg. Dose that has demonstrated cardiorenal benefits: • the CV benefits of exenatide-ER remain unproven Dose that has demonstrated cardiorenal benefits: • semaglutide 0.5mg and 1mg sc QD

A1C 1.8%

• • • • •

Weight loss 6 kg

Nausea 20% worse in first 24 hours

Diarrhea 12-13% Vomiting 6-8%

• No dose adjustment for mild to severe renal impairment. Caution • If eGFR <30 mL/min/1.73m 2 Contraindication • ESRD Each prefilled pen will deliver: • 2 mg/pen (has markings to deliver 0.25 mg or 0.5 mg doses) • 4 mg/pen (has markings to deliver only 1 mg dose) • Needle included with packaging.

Use limited as requires reconstitution • Significantly more steps required to do injection Caution • If eGFR 30-59 mL/min/1.73m 2 Contraindication • ESRD or eGFR <30 mL/min/1.73m 2 , and pancreatitis

Each prefilled pen: • 2 mg pen (4 pens) • Needle included.