A case report on use of dulaglutide during the first weeks of pregnancy in woman affected by type 2 diabetes mellitus
A boxed warning is the strongest safety-related warning issued by the FDA
Cynthia Maxwell MD, MBA, FRCSC, DABOM (Obesity Medicine), is the Medical Content Director of First Exposure, the Vice President, Medical Affairs & System Transformation and Lead Medical Executive at Womens College Hospital and Professor, Faculty of Medicine, Department of Obstetrics and Gynaecology and Division of Maternal Fetal Medicine at the University of Toronto
This appointment should include: Complete medication review : Disclose all prescription medications, over-the-counter drugs, and supplements Medical history assessment : Discuss previous mental health treatment, weight management attempts, and relevant conditions Baseline measurements : Blood pressure, weight, BMI, and potentially blood tests (renal function, liver function, HbA1c) Treatment goals : Establish realistic expectations for both depression management and weight loss Contraception discussion : If you're a woman of childbearing age, discuss effective contraception while taking semaglutide During treatment , contact your healthcare provider if you experience: Urgent concerns requiring same-day assessment : Suicidal thoughts or self-harm urges Severe, persistent vomiting or inability to keep fluids down Severe abdominal pain, especially if radiating to the back Signs of allergic reaction (rash, swelling, breathing difficulties) Rapid or irregular heartbeat with chest discomfort Non-urgent issues warranting routine review : Persistent nausea affecting daily activities or nutrition Significant mood changes or increased anxiety Troublesome side effects not improving after 23 weeks Lack of therapeutic response after adequate trial periods Weight loss exceeding recommended rates (approximately 0.51 kg per week) Regular monitoring schedule : For antidepressants, NICE guidance (NG222) recommends review within 24 weeks of initiation (within 1 week for people under 30 or at increased suicide risk), then as clinically indicated
Semaglutide is a medication used to treat type 2 diabetes by mimicking a hormone called GLP-1, which increases insulin secretion and lowers blood sugar levels
