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Newer compounds like retatrutide add a third receptor target (GIP, GLP-1, and glucagon) and may create unique nutritional challenges that have not yet been well-studied

Among these patients, 45.2% achieved a dose of 1 mg (injectable), and 14.2% reached 14 mg (oral) [1]

According to NICE guidance (NG28) , GLP-1 receptor agonists like Rybelsus may be considered when metformin is contraindicated or not tolerated, or as part of combination therapy when other treatments have not achieved adequate glycaemic control

A more serious but less common side effect of metformin is lactic acidosis, which can result in death, hypothermia, hypotension, and resistant bradyarrhythmias