Preoperative statin therapy is not associated with a decrease in the incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery
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Dipeptidyl peptidase-4 (DPP-4) inhibitors increase the bioavailability of both GLP-1 and GIP but the dogma continues to be that it is the increase in GLP-1 that contributes to the improved glucose homeostasis
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Now, patients have access to once-weekly injections and an oral formulation, semaglutide (Rybelsus), for those who prefer to avoid needles. GLP-1s and the ADA Guidelines: A New First-Line Therapy The American Diabetes Associations 2024 Standards of Care are clear: GLP-1 RAs are often first-line agents for patients with type 2 diabetes who also have atherosclerotic cardiovascular disease, chronic kidney disease, or obesity. For patients with a body mass index (BMI) of 30 kg/m or higher or elevated cardiovascular risk, semaglutide or tirzepatide may be considered before initiating metformin, especially when weight loss or cardioprotection is the top priority. More Than Just A1C Control While GLP-1s are effective for lowering blood glucose, the added clinical benefits are just as important: Weight loss : Many patients experience a reduction of 10 percent or more in total body weight. Cardiovascular protection : Liraglutide, dulaglutide, and semaglutide have demonstrated reductions in major adverse cardiovascular events. Renal protection : These agents may slow the progression of chronic kidney disease. GLP-1s are also being studied for a wide range of potential uses, including nonalcoholic steatohepatitis (NASH), obstructive sleep apnea, heart failure with preserved ejection fraction, and even Alzheimers disease. What APRNs Should Know Before Starting GI side effects, particularly nausea and vomiting, are the most common patient complaints
