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For patients interested in participating in research , the following resources may be helpful: NIHR Be Part of Research (bepartofresearch.nihr.ac.uk) search for Parkinson's and GLP-1 trials Parkinson's UK (www.parkinsons.org.uk) information on current research and trial opportunities When to contact your GP or specialist : If you have Parkinson's disease and diabetes, and wish to discuss whether a GLP-1 receptor agonist is appropriate for your diabetes management If you experience new or worsening symptoms whilst taking any medication If you are interested in clinical trial participationyour neurologist can advise on suitable studies Seek urgent medical attention if you experience: Severe, persistent abdominal pain (possible pancreatitis) Persistent vomiting or inability to keep fluids down (risk of dehydration) Signs of dehydration (extreme thirst, dark urine, dizziness) Allergic reaction (rash, swelling, difficulty breathing) Patients should never start, stop, or modify medications without medical supervision

Prespecified positive and negative controls To evaluate the validity of our approach, we conducted analyses using both positive and negative outcome and exposure controls

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A new dosage or potency A new drug combination, such as semaglutide mixed with vitamin B12 A new drug form, such as a liquid or pill rather than an injection Brunner thinks clinicians will increasingly take advantage of these exceptions: I think we'll see more prescribers move into the customized dosage side of compounding. Custom Dosages This customization has also fueled interest in microdosing GLP-1s, a technique in which patients take smaller amounts to try to achieve gradual weight loss or minimize side effects

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