Existing and emerging GLP-1 receptor agonist therapy: Ramifications for diabetic retinopathy screening.
George Iype VarugheseSarita JacobPublished in: The journal of the Royal College of Physicians of Edinburgh (2024)
GLP-1 receptor agonist treatment revolutionised the management of type 2 diabetes mellitus with significant enhancement of cardiovascular risk reduction. They have been instrumental in effectively managing the glycaemic control of this at-risk patient group. This class of drugs are associated with rapid improvement in glucose levels and consequently, transient early worsening of pre-existing diabetic retinopathy (DR) which is well-recognised, but this paradox is less commonly perceived in routine clinical practice. The recent shortage of supply has resulted in an enforced hiatus to prescribing all existing GLP-1 receptor agonists, which is expected to last all through 2024. This becomes even more pertinent as their DR could have progressed due to worsening HbA1c as a result of the unforeseen interruption to GLP-1 receptor agonist treatment. Therefore, when these medications are recommenced in a few months' time, all prescribers need to be aware of these patients' most up-to-date DR status and liaise with their affiliated screening service.
Keyphrases
- diabetic retinopathy
- clinical practice
- optical coherence tomography
- end stage renal disease
- mental health
- primary care
- newly diagnosed
- healthcare
- ejection fraction
- type diabetes
- chronic kidney disease
- editorial comment
- physical activity
- emergency department
- depressive symptoms
- case report
- adipose tissue
- prognostic factors
- metabolic syndrome
- peritoneal dialysis
- blood pressure
- brain injury
- sensitive detection
- subarachnoid hemorrhage