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SGLT2 inhibition reduces glucose reabsorption at the level of the proximal renal tubule, promotes urinary glucose excretion independent of insulin action, and causes a negative caloric balance (21, 22)

B12 supplementation may be beneficial, as some evidence suggests GLP-1 medications can affect B12 absorption over time

Standard protocols for semaglutideincluding branded options like Wegovy and Ozempicinvolve a titration schedule

Although they can be effective, it is essential to consider the financial aspects, as many of these medications are not covered by insurance and range from $200 to $2,000 monthly without coverage

Davies et al., JAMA 2021) reported psychiatric adverse events at similar rates between semaglutide and placebo groups, suggesting no clear direct causation

Siwamogsatham, O., Stephens, K