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Instead of jumping straight to GLP-1 medicationswhich he chose to avoid due to concerns about acid reflux and vocal healthhe worked with clinicians to lower insulin gradually through close monitoring, lifestyle changes, and a low dose of metformin

The authors claimed that this is particularly important given the lack of data on long-term safety (34)

On the other hand, Janumet may be more effective for patients with severe hyperglycemia, since it combines the mechanisms of sitagliptin and metformin to provide a more integrated approach to glycemic control

Moreover, it typically involves a limited number of sessions with enduring benefits, reducing the need for continuous care

A: You can, but side effects will be worse