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Whilst there is a gradual decline in semaglutide plasma concentrations between doses, several other factors typically contribute more significantly to day-to-day glucose fluctuations than the medication's pharmacokinetics alone

For example, ICD diagnosis codes for ophthalmic diseases can be unreliable and inaccurate, 49,50 particularly in national datasets in which manual validation of data is not possible

While standard protocols increase doses every four weeks, some patients benefit from slower escalation over 6-8 weeks, particularly those prone to gastrointestinal side effects

2018a;70:35468

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doi: 10.1136/ard.2006.062554 150 XuMHongRZhangXZouHZhangYHouZet al