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Areas to be covered in this Research Topic may include, but are not limited to: - Studies on the effect of SGLT2 inhibitors or GLP-1 receptor agonists on testosterone and gonadotropins in male patients with diabetes mellitus and hypogonadism - Studies on the effect of SGLT2 inhibitors or GLP-1 receptor agonists on testosterone gonadotropins in female patients with diabetes mellitus and polycystic ovary syndrome - Studies on the effect of SGLT2 inhibitors or GLP-1 receptor agonists on reninangiotensinaldosterone system in patients with diabetes mellitus and arterial hypertension - Studies on the effect of SGLT2 inhibitors or GLP-1 receptor agonists on Growth Hormone/IGF axis in patients with diabetes mellitus In patients with diabetes mellitus not achieving targets on lifestyle measures, pharmacologic therapy should be considered

Step 4: Submit Assessment and Await Provider Review After Submission : Receive immediate confirmation email Account shows "Assessment Under Review" status Expected provider review timeline: Within 48 hours (business days) During Review Period : Check email and Ro account regularly for updates Provider may request additional information Be ready to respond quickly to any requests Don't schedule travel or make major commitments until you know outcome Possible Outcomes : Immediate Approval : Provider writes prescription Proceed to medication selection (Step 5) Lab Testing Required : Provider orders metabolic panel Receive lab order through account Schedule Quest appointment or order at-home kit Complete testing within 1-2 weeks Await results and provider review (3-5 days after testing) Then proceed to approval or denial Additional Information Needed : Provider sends message requesting clarification Log into account to view request Provide requested information promptly Review resumes after submission Not Approved : Provider determines medication not medically appropriate Receive explanation of reasons Full refund of any membership fees paid May discuss alternative weight management approaches Step 5: Choose Insurance or Cash-Pay Pathway If Approved for Medication : Decision Point : Pursue insurance coverage OR pay cash for medication Choosing Insurance Pathway : When This Makes Sense : You have commercial (employer or marketplace) insurance Your plan covers prescription medications with reasonable copays You're willing to wait 2-4 weeks for authorization process You're prepared for possibility of denial Lower monthly costs more important than immediate access Process : Provide complete insurance information (if not already submitted) Ro's insurance concierge contacts your plan Verifies coverage and submits prior authorization Wait for coverage determination (2-4 weeks typical) If approved: Proceed to prescription fulfillment at pharmacy If denied: Can appeal or switch to cash-pay Choosing Cash-Pay Pathway : When This Makes Sense : Want to start medication immediately (1-4 days typical) Don't have insurance or have government insurance Ro can't assist with Insurance unlikely to cover or has denied in past Prefer predictable, transparent pricing Want access to LillyDirect Zepbound vials Avoiding insurance hassle worth higher cost Available Cash-Pay Options (verify current pricing at ro.co): Option 1: Zepbound Vials via LillyDirect (Lowest Cost) Starting dose (2.5mg): $349/month Escalation doses (5mg): $499/month Maintenance doses (7.5-15mg): $499/month* (*with timely refill check-ins) Fulfillment: Direct to home, 1-4 days typical Total with membership: $494-$644/month Option 2: Wegovy Pens via NovoCare All doses: $499/month Fulfillment: Direct to home, 1-4 days typical Total with membership: $644/month Option 3: Zepbound Pens All doses: ~$1,050/month May qualify for manufacturer savings with commercial insurance Total with membership: ~$1,195/month Process for Cash-Pay : Select preferred medication option Review and confirm pricing Enter payment information (credit card or PayPal) Complete purchase Prescription processed for fulfillment Medication ships within 1-4 days Receive tracking information Step 6: Receive Medication and Prepare for First Dose Medication Delivery : Tracking : Monitor shipment through tracking link emailed Delivery : Signature may be required for controlled medications Timing : Most shipments arrive within 1-4 business days Upon Receipt : Inspect Package : Check for damage to exterior packaging Verify temperature-controlled packaging intact Confirm medication matches prescription Verify Contents : Correct medication name and strength Appropriate quantity Expiration date (should be months away) Needles/syringes included (if applicable) Store Immediately : Place in refrigerator (36-46F) immediately Do NOT freeze Keep in original packaging Store securely away from children/pets Review Materials : Read prescribing information completely Watch administration video tutorials Review injection technique instructions Note provider contact information Prepare for First Injection : Supplies Needed : Medication (pen or vial) Needles (if using vials) Alcohol swabs Sharps disposal container Gauze or cotton balls (optional) Recommended Timing for First Dose : Day : Weekend or non-work day (in case side effects occur) Time : Evening (sleep through initial effects if nausea develops) Food : Can take with or without food