The weight loss, ataxia, and neutropenia caused by sitagliptin can be effectively managed through enhanced nutrition, environmental modification, and regular monitoring. When there are obvious signs of gait instability or infection (fever, sore throat), seek medical attention immediately and do not adjust medication on your own.

1、 Measures to cope with weight loss

1.1 Dietary Adjustment

Increase energy density: Add vegetable oil, cream, or protein powder to each meal, and prioritize high protein and high calorie foods (such as meat, eggs, and full fat dairy products).

Small and multiple meals: Increase to 5-6 meals per day, with snacks such as nuts and yogurt added between meals.

Nutritional support: If appetite continues to be low, oral nutritional supplements (such as Ansu and Nengtuan) can be used under the guidance of a doctor.

1.2 Monitoring frequency

Weigh yourself every 1-2 weeks, and if the weight drops by more than 5% within a month, promptly report to the physician.

2、 Mitigation strategies for ataxia

2.1 Environmental Safety

Remove obstacles (carpets, wires) from the home, install handrails in the bathroom, and ensure sufficient nighttime lighting.

When walking, use a cane or walking aid, and be accompanied when going up and down stairs.

2.2 Adjusting the pace of life

Avoid multitasking at the same time and complete activities such as dressing and eating while sitting down.

Adjust the medication time to bedtime (if allowed by the plan) to reduce daytime balance disturbances.

2.3 Rehabilitation Training

Perform 10-15 minutes of daily balance exercises (such as standing against a wall or standing on one leg with an object) to gradually improve coordination skills.

3、 Management of neutropenia

3.1 Blood routine monitoring

At the beginning of treatment, blood routine tests should be repeated every 2 weeks, and once stable, they can be extended to once a month.

3.2 Anti infection measures

Wash hands frequently, avoid going to crowded places, and wear masks when family members have a cold.

Pay attention to the integrity of the oral mucosa, use a soft bristled toothbrush to avoid gum damage.

3.3 Grading Processing

If the absolute neutrophil count (ANC) is below 1.0 × 10 ⁹/L, it is necessary to suspend the use of sitagliptin and consult a physician to determine whether to use granulocyte colony-stimulating factor (G-CSF) or reduce the dosage for restart.