Maria Masulli, Jan Tack, Giuseppe Esposito, Giovanni Sarnelli
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引用次数: 0
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists, such as tirzepatide, have transformed the management of type 2 diabetes and obesity through durable glycemic control, weight reduction, and cardiovascular protection. However, their widespread use has revealed a high incidence of gastrointestinal adverse events, particularly dyspepsia and gastroparesis-like symptoms. While most effects are transient, a significant subset of patients develop persistent intolerance, often leading to misdiagnosis, unnecessary investigations, or premature treatment discontinuation. Current therapeutic options remain limited, with guidelines offering little direction for managing symptoms, in this subset of dyspeptic patients. This growing clinical challenge highlights the urgent need for structured strategies, including risk stratification, tailored dose titration, and multidisciplinary care, to balance metabolic efficacy with gastrointestinal tolerability.
期刊介绍：
Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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