Starting with lower doses and gradually increasing them often provides the best experience
Jardiance presents a different side effect profile centered on urinary and genital tract infections, occurring in roughly 10% of users due to elevated glucose in urine creating an environment where bacteria thrive
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Patients should be advised to: Inspect feet daily for injuries, blisters, or colour changes Wear well-fitting footwear and avoid walking barefoot Maintain good foot hygiene and moisturise dry skin (avoiding between toes) Seek same-day assessment by the multidisciplinary foot care service for any new foot wounds, signs of infection, or sudden changes in foot shape Attend annual diabetes reviews incorporating the Nine Care Processes, including foot screening Referral to specialist services is appropriate when: Neuropathic pain remains inadequately controlled despite optimised primary care management Diagnostic uncertainty exists regarding neuropathy aetiology, or features are atypical or rapidly progressive Foot ulceration, infection, or suspected Charcot arthropathy develops (same-day referral to multidisciplinary foot care service per NICE NG19) Severe infection or critical limb ischaemia (emergency hospital admission) Severe autonomic symptoms significantly impair quality of life Patient engagement through diabetes self-management education empowers individuals to optimise lifestyle factors including diet, physical activity, and smoking cessationall contributing to improved metabolic control and reduced complication risk

And it also explains why pairing lifestyle change with GLP-1 drug therapy, for those who choose medication, can produce better results than taking the drugs alone