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Most of the trials were conducted in middle- and high-income countries, with little or no representation from regions such as Africa, Central America, and Southeast Asia
Key factors influencing dose selection include: Treatment goals : Whether the primary aim is glycaemic control, weight reduction, or cardiovascular risk reduction Baseline HbA1c and blood glucose levels : Higher values may eventually require higher maintenance doses Body weight and BMI : Particularly relevant for weight management indications Renal function : Most GLP-1 medications (semaglutide, liraglutide, dulaglutide) do not require dose adjustment for kidney impairment, but exenatide and lixisenatide should be used with caution or avoided in severe renal impairment Concurrent medications : Especially other glucose-lowering agents that might increase hypoglycaemia risk Previous medication tolerance : History of gastrointestinal sensitivity influences titration speed Cardiovascular history : Some GLP-1 medications have proven cardiovascular benefits at specific doses Diabetic retinopathy status : Rapid improvement in blood glucose can temporarily worsen retinopathy, particularly with semaglutide [22] [23] Your doctor will typically schedule regular follow-up appointments during the initial months of treatment
doi: 10.1002/pds.1742, 74
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