Obese female diabetic in reproductive age anticipating pregnancy.
but then safety of SGLT2 inhibitors in fertility not yet vcertified and i think they may be teratogenic althoughsome work is being done with GLP1 agonists in countries where theyare available-know asbout studies with exenatide combined with long acting insulin but dont know about liraglutide but dont know of any studies of trials with SGLT2 trials and think potentially with their mechanism of action teratogenicity has to be kept in mind since we r dealing with the infertilke population.
The first question is how the woman is treated so far and what are her blood glucose levels in daily live? Regarding a treatment with SGLT-2-inhibitors I would be skeptical because of possible side effects (infections of the urinary tract or of the genital tract) also with regard to the child's development.
Another question arises is, whether the wish to get pregnant could be an additional motivation for the woman to do something for her weight. Perhaps it will be helpful for this woman to support her for weight reduction psychologically, too?
SO FAR WE TRY TO USE MONTHERAPY WITH TOPiramate or bupropion with naltrexone withg combination drugsd working in addition to the antidia with glp1 agonists which has direct antiobesity effect as well as controls sugars it is much more convenient with insulin comn=bination although we have to omit those drugs before attempotring pregnancy as safetry profile nor sure .
WELL RIGHT NOW IN INDIA we have to import extendin or ligarutide and thatway it turns out to be very costly for our patients even if we are succesful and once they are introduced it has to be approved by our so called equivalent of your fdi .
what results are you getting vis a vis metabolic labs with the combination of Topiramate and naltrexone? Insulin? glucose? estradiol? LH? FSH? leptin?
Dear Dr. Kulvinder kochar kaur,
I can answer without any background of the field. As simple that infertility is inversely proportional to diabetic level.
answering julie o Tool ,we dont find much changes in FSH/LH,insulin glucose with topiramate and have used nalrexone buprion v sparingly as patients dont like to be put on naltrexone as it is a label for antiaddition which the pharmacist labels -kulvinder
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