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The warmth patients feel is the subjective experience of elevated energy expenditure

1065 With respect to pilots with DM, recent experience in Europe reported no episodes of pilot incapacitation nor worsening of glycemic control with insulin-treated DM

Side effects Nausea (38-43% depending on dose most common side effect, typically peaks during titration and improves after 8-12 weeks of gradual dose escalation) Diarrhea (33-35% dose-dependent, usually mild to moderate severity, manageable with dietary adjustments) Vomiting (20-21% more common at higher doses and during rapid titration, often resolves with slower dose escalation) Constipation (22-25% can occur alternately with diarrhea during dose adjustment periods) Decreased appetite (18-19% related to GLP-1 mechanism of action, distinct from nausea-related food avoidance) Dysesthesia (8.8% at 9 mg, 20.9% at 12 mg vs 0.7% placebo NEW safety signal identified in Phase 3 TRIUMPH-4, not observed in Phase 2

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Viscosity increases at lower temperatures, meaning cold Retatrutide resists flowing through the needle more than warmed medication

Nauck et al., 2020): Compounds based on the lizard-derived exendin-4 peptide and compounds based on the human GLP-1 peptide