Question: Hello, I am a 70 year old man who has had Type II for nearly 20 years. I take 1000mg of Metformin Mod ER twice a day. 3 months ago my A1c climbed to 8.7 and my Doctor put me on Bydureon, 1 injection per week at 2mg. I have had no side effects. After 3 months my reduction has only been to 8.3 and at my last visit he is switching me to Ozempic. In reading the insert that comes with Ozempic it states that I should begin with a dosage of .25 mg a week, followed by an increase to .5 mg per week. My question is this: Since they are both GLP-1 agonists, do I still need to take the .25 mg dose for 4 weeks before increasing? I ask because the insert says that the .25 mg dose is insufficient to affect my blood glucose, and that will only occur when I begin the .5 mg dose (which I understand can be increased to 1 mg per week). Thank You.

Thank you very much Dr. Guni.

According to recently done blood tests my kidney function is normal. From what you are saying it sounds like it is reasonable to ask my Doctor to put me on triple therapy (Metformin, Ozempic, and Invokana). Am I correct?

Last, generally speaking, approximately how many weeks should it take for me to see the maximum benefit from the Ozempic and Metformin therapy?

Thank you so much. XXXXXXX