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More serious risks include pancreatitis (requiring immediate medical attention if severe abdominal pain occurs), gallbladder disease, and a boxed warning for medullary thyroid carcinoma risk (contraindicated in patients with personal/family history of MTC or Multiple Endocrine Neoplasia syndrome type 2)

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Several experts advise to lower the dose of sulfonylurea and short-acting and low-acting insulin analogues prior to or during titration of GLP-1RA therapy, to reduce the risk of (severe) hypoglycemia ( Gastrointestinal (GI) Adverse Effects In the phase 3 trials, both oral and subcutaneous semaglutide were associated with gastrointestinal disturbances, such as nausea, vomiting and diarrhea, well-known effects from this drug class

The resulting fibrovascular proliferation can exert traction on the retina, increasing the risk of tractional retinal detachment, a severe and vision-threatening complication that underscores the pathological role of aberrant neovascularization in advanced DR