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Abstract Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic beta cells, resulting in the lifelong need for exogenous insulin

In July, North Carolina Medicaid provided a public notice of the estimated annual cost to state taxpayers for GLP-1s for weight loss

This physical effect contributes to prolonged feelings of fullness, helping to manage portion sizes and prevent overeating

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Clinical implementation: adherence is a key determinant of success The therapeutic effectiveness of oral semaglutide depends on strict administration rules: 1 Take the tablet first thing in the morning on an empty stomach 2 Use no more than 120 mL of plain water 3 Wait at least 30 minutes before eating, drinking, or taking other oral medications 4 Swallow the tablet whole without crushing, splitting, or chewing A structured dose escalation strategy is essential to improve tolerability: Month 1: 1.5 mg daily Month 2: 4 mg daily Month 3: 9 mg daily Maintenance: 25 mg daily Safety profile and clinical management The most frequent adverse events are gastrointestinal and generally transient: Nausea Vomiting Dyspepsia and gastroesophageal reflux symptoms Management strategies include: smaller meals adequate hydration and fibre intake limiting alcohol, carbonated beverages, and high-fat/spicy foods gradual dose escalation and proactive patient communication Special attention is required for: thyroid function monitoring with concomitant levothyroxine therapy temporary discontinuation before procedures requiring general anesthesia due to delayed gastric emptying risk avoidance during pregnancy and breastfeeding Oral semaglutide expands therapeutic options in obesity management