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Patients may need a more careful discussion if they have a history of: Previous NAION in one eye Significant optic nerve crowding Diabetes with vascular complications Sleep apnea, especially untreated sleep apnea High blood pressure or low nighttime blood pressure Cardiovascular disease Sudden unexplained vision loss in the past This does not automatically mean a GLP-1 medication is unsafe, but it does mean the patient should have a personalized risk-benefit discussion with their medical provider
This process is called lipolysis

Novo Nordisk's approach with Rybelsus was different: co-formulate semaglutide with SNAC, a small fatty acid derivative that temporarily increases stomach pH and enhances paracellular transport across gastric epithelial cells

Surprisingly, both Gcg and Dpp-4 genes are also expressed in platypus and echidna venom (Fig

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