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As a general clinical principle: Retest HbA1c no sooner than three months after commencing B12 replacement therapy, and ideally once haematological recovery has been confirmed Confirm haematological recovery normalisation of MCV and haemoglobin before interpreting the repeat HbA1c as reliable Use interim glucose monitoring such as fasting plasma glucose, OGTT, or self-monitored blood glucose (SMBG) to assess glycaemic control during the treatment period

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The higher doses and costs are justified by accelerated timelines in appropriate contexts

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(3) As a result, people who are at risk of kidney disease or are currently treating acute kidney disease should first talk to a health care provider before using semaglutide

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