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Unfortunately, the study was prematurely terminated and underpowered, which precludes a conclusive determination of the disease-modifying effects of exenatide for MCI or early AD in clinical settings [95]

The somatotropic axis in human aging: framework for the current state of knowledge and future research

10% excreted unchanged by the kidney hepatic dysfunction Glimepiride: (Amaryl) monotherapy -- once a day administration or in combination with insulin most potent -- lowest dose of the sulfonylureas long duration of action: half-life = 5 hours hepatic metabolism: complete to inactive products Secondary Failure and Tachyphylaxis to Sulfonylureas: Treatment failures occur Possibly due to pancreatic B cell refractoriness or to loss of dietary compliance Combination of sulfonylureas and insulin would appear justified only in the presence of severe insulin resistance Biguanides Metformin: (Glucophage) Proposed Mechanism of Action: glycolysis stimulation-- increased glucose removal from blood decreased hepatic gluconeogenesis decreased glucose absorption rate from the GI tract reduced plasma glucagon in patients with refractory obesity and insulin resistance Advantages: does not cause hypoglycemia does not increased weight May be used in combination with sulfonylureas when sulfonylurea monotherapy is not effective Toxic/adverse effects: most common -- gastrointestinal (20% frequency) anorexia, nausea, vomiting, diarrhea dose-related usually occurs upon initiation of therapy -- often transient in effect Decreased vitamin B12 absorption

Fatigue: Feeling tired or lacking energy, usually occurring early in treatment and subsiding as the body adjusts