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Practical precautions for people with diabetes: never drink on an empty stomach, check blood glucose before and after drinking and before bed, be aware that hypoglycemia symptoms (confusion, slurred speech, unsteadiness) overlap with intoxication symptoms, and tell someone you are with what to watch for

For patients with thyroid disease specifically, the HealthRX.com Medical Team recommends: closer TSH monitoring in the first 6 months of GLP-1 therapy, discussion of the MTC boxed warning with an endocrinologist (not a reason to avoid the drug in most cases, but a reason to have the conversation), and awareness that levothyroxine absorption timing may need adjustment

Aziz MT, Al-Asmar MF, Mostafa T, Atta H, Rashed L, Sabry D, et al

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