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Metformin exerts its anti-diabetic effects through several mechanisms, such as inhibition of hepatic gluconeogenesis, reduction of insulin resistance, and enhancement of peripheral glucose uptake

NICE guidance recommends reviewing the continued need for GLP-1 receptor agonists if HbA1c has not reduced by at least 11 mmol/mol (1.0%) and weight loss of at least 3% of initial body weight has not been achieved within six months of reaching the maximum tolerated dose

Antithyroid Drugs therapy or surgery Risks: Teratogenicity ( methimazole Methimazole A thioureylene antithyroid agent that inhibits the formation of thyroid hormones by interfering with the incorporation of iodine into tyrosyl residues of thyroglobulin

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