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6.2 Non-insulin agents Use of metformin should be considered for patients with insulin resistance and those who are overweight, although GI side effects that affect tolerability are often considered ( There is a risk of hypoglycemia and sulfonylureas are largely ineffective ( Their use is limited to the experimental realm, as there is little to no efficacy from DPP-4 inhibitors, GLP-1 receptor agonists and dual GLP-1 and GIP agonists like Tirzepatide due to the already deficient secretion of incretins ( 6.3 Pancreatic enzyme replacement therapy Pancreatic Enzyme Replacement Therapy (PERT) substantially aids in the treatment of Exocrine Pancreatic Insufficiency (EPI) and indirectly helps improve the control of hyperglycemia ( Mechanisms behind the benefits include the following