The mechanisms do not conflict
They are not competing versions of the same solution
These drug supply issues are a great opportunity to have patient management reviews, emphasise principles around healthy lifestyle, and review therapies including prescribing options or even de-prescribing if possible. Alternative treatment options suggested by the RACGP include: Liraglutide, which is administered once daily and has evidence of cardiovascular benefit, but is not subsidised by PBS SGLT-2 inhibitors, especially in those who also have cardiovascular disease, multiple cardiovascular risk factors and/or kidney disease DPP-4 inhibitors, which may be useful in those who do not have cardiovascular disease, multiple cardiovascular risk factors or kidney disease, and are unable to achieve optimal blood glucose levels Sulphonylureas or insulin (initiation or titrated doses), but these may lead to risks for hypoglycaemia and weight gain The twice daily exenatide (Byetta) is not recommended as a potential substitute, as it has been discontinued and is also no longer available
A qualified provider will always tailor this schedule to your specific B12 levels and health goals
The other is an oral dose
Obesity management often requires a multifaceted approach, including dietary modifications, exercise, medications, behavior therapy, and, in some cases, bariatric surgery
