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Patients should be counselled about realistic expectations, potential side effects, and the importance of continued thyroid monitoring throughout treatment
Appropriate dosing strategies
The position document summarized that the efficacy of DPP-4 inhibitors to lower glucose is intermediate when compared to other therapies, that DPP-4 inhibitors are neutral in relation to change in body weight, that major side effects are rarely seen for DPP-4 inhibitors, that the risk for hypoglycemia is low and that the cost is high
This matters because visceral fat is the metabolically active fat that secretes inflammatory cytokines, drives insulin resistance, and deposits fat in the liver
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