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Association of GLP-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases

Peter Winocour, 1 Stephen C Bain, 2 Tahseen A Chowdhury, 3 Parijat De, 4 Ana Pokrajac, 5 Damian Fogarty, 6 Andrew Frankel, 7 Debasish Banerjee, 8 Mona Wahba, 9 Indranil Dasgupta 10 1 ENHIDE, QE2 Hospital, Welwyn Garden City, UK 2 Swansea University, Swansea, UK 3 Royal London Hospital, London, UK 4 City Hospital, Birmingham, UK 5 West Hertfordshire Hospitals, UK 6 Belfast Health and Social Care Trust, Belfast, UK 7 Imperial College Healthcare NHS Trust, London, UK 8 St Georges Hospital, London, UK 9 St Helier Hospital, Carshalton, UK 10 Heartlands Hospital, Birmingham, UK Address for correspondence: Dr Peter Winocour Consultant Physician and Clinical Director for Diabetes and Endocrine Services, ENHIDE, QE2 Hospital, Welwyn Garden City, Hertfordshire AL7 4HQ, UK Telephone: +44 (0)7880 702291 Email: [email protected] The ABCD Renal Association guidelines on managing hyperglycaemia in patients with diabetes and kidney disease (DM CKD) are evidence based with recommendations graded accordingly

Additionally, there are ongoing clinical trials to further explore the effectiveness of long-acting GLP-1s in individuals with T1D and insulin resistance

This typically includes: Blood glucose monitoring (if diabetic) Kidney function tests (urea, creatinine, eGFR) Electrolytes and bicarbonate levels (to detect metabolic acidosis) Weight and body mass index tracking Blood pressure monitoring Practical considerations such as: How to administer Ozempic injections correctly Dose escalation schedules (Ozempic is typically started at a low dose and gradually increased) What to do if you miss a dose How to manage side effects When to seek urgent medical attention Pregnancy planning or contraception