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This medication is administered as a weekly subcutaneous injection with doses ranging from 2.5 mg to 15 mg, titrated based on efficacy and tolerability

Although low serum B12 levels have been associated with increased bone turnover and fracture risk (9) , long-term B12 and folic acid supplementation did not improve bone mineral density (38) , or reduce osteoporotic fracture incidence in elderly individuals with elevated plasma homocysteine levels (39)

This tolerance development explains why side effects are most prominent during treatment initiation and dose escalation but decline substantially with continued use

Before injection, that powder must be dissolved into a liquid carrier and bacteriostatic water is the standard choice because the 0.9% benzyl alcohol in it prevents microbial contamination during the multi-week dosing period

Although semaglutide has not yet been assessed in T1D in clinical trials, retrospective data of off-label use has suggested benefits in reducing HbA1c, weight and insulin requirements 19,20