Episode 258
Optimising GLP-1 Use: Indications, Titration, and Monitoring
In this episode of The Good GP, Dr Sean Stevens speaks with Dr Terri-Lynne South, GP and medical director of Lifestyle Metabolic, for a focused discussion on the practicalities of prescribing GLP-1 medications. Dr Terri-Lynne shares her experience with increasing GP interest in GLP-1s, outlining both established and new indications such as type 2 diabetes, obesity, cardiovascular disease prevention, metabolic-associated steatotic liver disease (MASLD), chronic kidney disease, and obstructive sleep apnea.
Dr Terri-Lynne provides clear, evidence-based guidance on dose titration, emphasising the importance of starting low and progressing gradually to minimise side effects, with schedules tailored to individual patient response. She recommended baseline and follow-up monitoring, including the use of the Bristol stool chart for baseline gastrointestinal assessment.
Examining physiological effects and timelines following the discontinuation of GLP-1 therapy, with typical patterns of weight regain and metabolic reversal.
Finally, highlighting the evolving role of GLP-1s as disease-modifying agents and flags upcoming advances such as dual and triple agonists and new oral medications. Dr Terri-Lynne concludes by advising GPs to set realistic patient expectations and understand the long-term management necessities of chronic disease.
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