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[25] Instead, the guidelines emphasize comprehensive cardiometabolic risk reduction through improved glycemic control, weight management, blood pressure control, and lipid management

When to investigate poor response Losing less than 5% body weight by week 12 despite consistent dosing and reasonable dietary adherence signals need for evaluation

Some people can taper off successfully, especially if lifestyle habits are well established

Furthermore, patients who drastically reduce caloric intake may experience fatigue and lightheadedness related to inadequate energy substrate availability, even in the absence of frank hypoglycemia

The standard titration schedule begins with 2.5 mg once weekly for 4 weeks, then increases in 2.5 mg increments every 4 weeks up to the target dose of 15 mg as tolerated