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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