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Practical Considerations for Starting GLP-1 with Metformin When a patient already takes metformin and begins semaglutide, the typical approach involves maintaining the metformin dose while initiating the GLP-1 agonist at a low starting dose, then titrating upward over weeks based on tolerability and glycemic response

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Glycogen synthase kinase-3 (GSK-3) is a serine/threonine kinase that is involved in numerous intracellular signaling pathways