It is important to note that SOUL was designed as a CV safety and efficacy trial, not a dedicated kidney outcomes trial
The authors also noted several limitations
No prior authorization
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Pre-treatment assessment should include: BMI calculation and confirmation of eligibility criteria (BMI 30 kg/m or 27 kg/m with weight-related comorbidities such as type 2 diabetes, hypertension, or dyslipidaemia) Medical history review , including thyroid disease, pancreatitis, gallbladder disease, and cardiovascular risk factors Current medications , particularly antidiabetic agents that may require dose adjustment Pregnancy status and contraception counselling where relevant (Wegovy should not be used during pregnancy and should be discontinued at least 2 months before planned conception) [12] [13] Baseline investigations : HbA1c (if diabetic or at risk), lipid profile, liver function tests, and thyroid function tests as clinically indicated Discussion of realistic expectations : Wegovy is most effective when combined with lifestyle modifications, not as monotherapy Dosing schedule follows a gradual escalation protocol to minimise gastrointestinal side effects: Weeks 14: 0.25 mg once weekly Weeks 58: 0.5 mg once weekly Weeks 912: 1 mg once weekly Weeks 1316: 1.7 mg once weekly Week 17 onwards: 2.4 mg once weekly (maintenance dose) If patients experience intolerable side effects, the dose escalation may be delayed
Soluble fibre forms a gel-like substance in the gut that slows digestion, stimulates GLP-1 release, and helps regulate blood sugar levels
