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[33, 34, 35, 36] Mechanism: Typically pre-renal, occurring in the setting of volume depletion from GI losses (nausea, vomiting, diarrhea, reduced oral intake) More frequently seen at higher, obesity-level doses Although generally reno-protective long term, post-marketing data describe acute rises in creatinine following days to weeks of significant GI symptoms Risk factors: Underlying chronic kidney disease Concomitant use of ACE inhibitors, ARBs, diuretics, or SGLT2 inhibitors ED Management: IV fluids Hold GLP-1 and contributing medications Usually reversible with supportive care Future Directions GLP-1 receptor agonists are rapidly evolving beyond their original indications in diabetes and obesity

As will be discussed below many of the non-glucose lowering benefits and side effects of SGLT2 inhibitors can be explained by the increase in glucose excretion in the urine

Injectable: Comparing Frequency and Convenience If weekly injections don't appeal to you, PlexusDx offers oral semaglutide ($289/mo) and oral tirzepatide ($349/mo) as alternatives

Never leave it at room temperature for extended periods

8 Conclusions Semaglutide, like many other GLP-1R agonists, is used in diabetes and obesity to decrease glucose levels and manage body weight, which plays a role in tumorigenesis

These are remarkable numbers that represent a genuine breakthrough in medical weight management