Overall, the effects of these compounds on fat metabolism, body mass index, lean mass, and insulin sensitivity might show changes in body weight on long-term treatment, yet they are less likely to offer the same results as GLP-1 patches
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Investigations that may be considered include: Blood tests to assess renal function, electrolytes (sodium, potassium, magnesium, calcium), glucose control (HbA1c), and thyroid function Creatine kinase (CK) if myopathy is suspected, particularly in patients taking statins Vitamin and mineral levels (vitamin D, vitamin B12) if deficiency is suspected Medication review to identify potential drug interactions or adverse effects Urgent medical attention is required if leg cramps are accompanied by: Severe pain with muscle swelling and warmth (possible deep vein thrombosis) contact NHS 111 or GP for same-day assessment Dark or cola-coloured urine (potential rhabdomyolysis, though extremely rare) Chest pain or severe breathlessness call 999 immediately Patients should be reassured that with appropriate assessment and management, leg cramps can usually be effectively controlled, allowing continuation of beneficial GLP-1 therapy under medical supervision

Overall, our findings can contribute to guidance for rational GLP-1RA usage in Asia,suggesting that GLP-1 analogues are desirable for T2D patients with normal BMI as well as for those with overweight/obesity
In line with prospective studies, these results highlight the function of the HPA-axis during the peripubertal period as a possible factor associated with greater vulnerability to internalizing symptoms [13] and emphasizes that this vulnerability may be exacerbated in females due to the emergence of sexually dimorphic HPA-axis regulation [68, 69]
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