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The tradeoffs are different Metformin Usually inexpensive and available as a generic Often causes diarrhea, nausea, or stomach discomfort at first Extended-release formulations may be easier to tolerate May require vitamin B12 monitoring with long-term use Has much more pregnancy-related clinical experience than newer GLP-1 medicines GLP-1 or GIP/GLP-1 medicines Can substantially reduce appetite and weight in eligible patients Commonly cause nausea, constipation, reflux, or diarrhea May make it difficult to eat enough protein, fiber, and micronutrients Can be expensive or difficult to access consistently Are not recommended during pregnancy and require a preconception plan Often require long-term treatment to maintain the full effect Can they be used together
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In a recent issue of Science , Auger et al
"Triple-Agonist Approaches in Metabolic Therapeutics: Mechanisms and Clinical Applications." Journal of Pharmaceutical Sciences, 2024
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