Practical applications of therapy with a glucagon-like peptide-1 receptor agonist.

Patients such as ML represent a common challenge in the primary care management of patients with T2DM. After some response to initial therapy with lifestyle management and metformin, the A1C goal of <7.0% after 2 to 3 months was not achieved, necessitating the initiation of combination therapy. The 4 groups of medications recommended by the ADA/EASD panel as the preferred therapies are basal insulin, the sulfonylureas, the TZD pioglitazone, and GLP-1 receptor agonists. In addition to considering efficacy, safety, cost, and other medication-related factors, the treatment plan must take into account the patient's individual needs, concerns, and capabilities. These additional considerations help to foster increased patient self-management and greater treatment adherence. To achieve these objectives, comprehensive patient education is essential. The unique mechanism of action of the GLP-1 receptor agonist class of medications makes these agents a desirable choice as add-on therapy to metformin.