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The theoretical rationale centers on several observations
Clin Chem 64:6471
Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis combining 177 randomized controlled trials with a median follow-up of 26 weeks
What is new are these longer-acting formulations with monthly or quarterly injections
They are custom-prepared formulations created when licensed providers determine medical necessity based on individual patient needs or during drug shortage situations
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The dual mechanism gives it an edge in patients without diabetes in particular
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