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Patient safety advice includes: Maintaining good injection technique and site rotation to minimise local reactions Staying up to date with routine vaccinations, including annual influenza and pneumococcal vaccines as recommended for people with diabetes Monitoring for signs of infection and seeking prompt medical advice if concerned Following 'sick day rules' during illness maintain hydration, continue medication if possible, but temporarily pause GLP-1 treatment if unable to keep fluids down Reporting suspected side effects via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk or the Yellow Card app) Patients should not discontinue their GLP-1 receptor agonist due to concerns about immune function without first consulting their prescribing clinician

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In several RCTs, GLP-1 receptor agonists were compared with insulin or insulin-based intensification strategies, therapies that have been associated with hyperinsulinemia and potential pro-proliferative signaling