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any cloudiness may indicate protein aggregation or microbial contamination Visible particulate matter: Floating particles, fibres, or sediment are a clear contraindication to use Discolouration: A yellow, brown, or otherwise abnormal colour change suggests chemical degradation Persistent foaming: Foam that does not resolve after gentle swirling can indicate denaturation of the peptide Leaking or compromised vial: Any sign of vial damage should result in immediate disposal It is important to note that a solution can appear visually normal yet still have reduced potency due to chemical degradation that does not alter its appearance

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Abbreviations ATC: Anatomical Therapeutical Chemicals CI: Confidence interval HR: Hazard ratio ICD: International Classification of Disease IQR: Interquartile ranges NAION: Nonarteritic anterior ischemic optic neuropathy SGLT2: Sodium-glucose transport protein 2 STROBE: Strengthening the Reporting of Observational Studies in Epidemiology T2D: Type 2 diabetes References Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jodar E, Leiter LA, et al