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(4) Heffernan MA, Thorburn AW, Fam B, Summers R, Conway-Campbell B, Waters MJ, Ng FM

Further studies are needed to confirm the lower B12 levels in relation to obesity or semaglutide use, and their effect when combined with GLP-1 drugs

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While this effect appears to be related to the magnitude and rapidity of glucose lowering rather than a direct effect of the medication itself, patients with a history of diabetic retinopathy should undergo careful ophthalmologic evaluation before and during treatment, and the potential risks should be weighed against the expected benefits of improved glycemic control