semaglutide for ra GLP-1 T2D Current evidence suggests GLP1-RA diabetes

Baseline assessment should include: Comprehensive medical history focusing on personal and family history of thyroid disease and endocrine tumours Current medications review to identify potential drug interactions Baseline HbA1c, renal function, and liver function tests Assessment of diabetic complications, particularly retinopathy Discussion of gastrointestinal symptoms and previous tolerance of incretin-based therapies Ongoing monitoring recommendations include: Regular review of glycaemic control and adjustment of concomitant diabetes medications to prevent hypoglycaemia, particularly if used with insulin or sulphonylureas Monitoring for gastrointestinal adverse effects (nausea, vomiting, diarrhoea), which are most common during dose escalation Assessment of weight loss trajectory and nutritional status Periodic renal function monitoring, especially in patients experiencing significant gastrointestinal side effects that may lead to dehydration Vigilance for symptoms suggestive of pancreatitis (persistent severe abdominal pain) if pancreatitis is suspected, tirzepatide should be discontinued immediately and not restarted if pancreatitis is confirmed Awareness of gallbladder disease risk, which may be increased with GLP-1 receptor agonists and significant weight loss patients should report right upper quadrant pain, fever, jaundice or other biliary symptoms Thyroid-specific precautions include educating patients about symptoms that warrant medical attention, such as a neck lump, hoarseness, dysphagia, or dyspnoea

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Christian et al., 2013)

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