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More than 70% of American adults are overweight or obese, and nearly 1 in 3 adolescents between 12 and 17 has prediabetes
55 GLP-1 RAs have demonstrated substantial weight loss effects in clinical trials, with weight reduction typically plateauing after 2060 weeks of treatment, depending on the specific agent
The standard protocol from the SUSTAIN trials (Marso et al., New England Journal of Medicine , 2016): Reduce basal insulin dose by 20% on the day you start semaglutide Monitor fasting blood glucose daily for the first 2 weeks Further reduce basal insulin by 10 to 20% if fasting glucose drops below 80 mg/dL or if hypoglycemia occurs Reduce mealtime (bolus) insulin by 20 to 30% during semaglutide titration, adjusting based on post-meal glucose readings Most patients on basal insulin end up reducing total daily insulin dose by 30 to 50% by the time they reach maintenance semaglutide dose
Each one was gradual
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Most patients notice improvements in sleep and energy within one to two weeks, with body composition changes developing over four to eight weeks
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