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Certain individuals, such as those with a familial history of thyroid issues like medullary thyroid cancer or multiple endocrine neoplasia type 2, may need to consult their provider for alternatives

Zhu M., Guan R., and Ma G., Efficacy and Safety of Teneligliptin in Patients With Type 2 Diabetes Mellitus: A Bayesian Network MetaAnalysis, Frontiers in Endocrinology 14 (2023): 1282584

This comparison illustrates why the appropriate amount, and whether a patient should aim toward the upper titration tiers at all, depends heavily on which compound a provider has selected and how that patients body responds throughout treatment