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Scientific references Wu G, Fang YZ, Yang S, Lupton JR, Turner ND

However, when starting a GLP-1 agonist in someone already on basal insulin, the insulin dose often needs to be reduced by 10 to 20 percent to prevent hypoglycemia

Marzilawati AR, Ngau YY, Mahadeva S

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Individual sensitivity or pre-existing heart conditions Some people are simply more sensitive to changes in heart rate, or they may have underlying heart conditions that make them more prone to noticing palpitations