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In summary, in patients with pasireotide-related hyperglycaemia we suggest starting GLP1-RA and metformin as a first-line approach and avoiding DPP4-i, in accordance with the findings of the previous studies (120, 121) and to the mild anti-hyperglycaemic effects of DPP4-i ( Figure 3 )

Choosing the best fibre whilst on GLP-1 medications such as semaglutide (Ozempic, Wegovy) or liraglutide (Saxenda, Victoza) is essential for managing digestive side effects and optimising treatment outcomes

Specialized treatments would also be provided through the IVI RMA North America network of fertility clinics