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Before starting GLP-1 medications: Ensure you've had a recent diabetic eye screening (within the past 12 months) Discuss your retinopathy status with your prescribing clinician If you have known retinopathy, consider ophthalmology review before initiation Understand that gradual dose titration may help avoid very rapid changes in blood glucose, which is a general principle in diabetes management During treatment: Attend all scheduled diabetic eye screening appointments without fail If you have pre-existing retinopathy, your diabetes team may consider more frequent monitoring based on your individual clinical situation Control blood pressure to target levels (below 140/90 mmHg, or below 130/80 mmHg if you have kidney, eye or cerebrovascular damage, if tolerated) [13] Maintain good overall glycaemic control whilst avoiding excessively rapid HbA1c reductions when possible Stop smoking if applicable, as tobacco significantly worsens diabetic eye disease Manage cholesterol levels according to NICE guidance for cardiovascular risk reduction Communicate openly with your healthcare team about any visual symptoms, even if they seem minor
Similarly, tirzepatide dose escalation from 5 mg to 7.5 mg, 10 mg, or even 15 mg can break through plateaus
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When muscle mass decreases, your joints may become less stable, increasing the risk of discomfort or injury
For other weekly GLP-1 agonists like dulaglutide, the standard recommendation is also at least 72 hours between doses
2023;12(11):e230257
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