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Oral option: Dual GIP/GLP-1 agonist: NICE recommends GLP-1 receptor agonists for type 2 diabetes (NG28) when metformin and other oral agents are insufficient, typically in patients with a BMI 30 kg/m (adjusted for ethnicity) or where weight loss would benefit other obesity-related comorbidities

J Fam Med Prim Care

Instead, communicate the timing and severity of shedding, review the pace of weight loss and nutritional tolerance, and allow the treating clinician to determine whether any dose modification is medically appropriate

However, COC use is also associated with impaired fasting glucose, insulin resistance, and an elevated risk of thromboembolic events (85)