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Less commonly recognized but still valid qualifying conditions include prediabetes (elevated fasting glucose or A1C between 5.7-6.4%), polycystic ovary syndrome, non-alcoholic fatty liver disease, osteoarthritis of weight-bearing joints, and chronic kidney disease

However, many patients prefer injecting after a small meal because it helps them avoid nausea in the minutes following the shot

The extent of high-turnover bone loss suggests severe bone impairment

Though these adverse effects may be common, they are not of severe or fatal nature

A key limitation of this review is the absence of formal quality appraisal using established tools such as the Cochrane Risk of Bias Tool or GRADE