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The reconstituted solution should be refrigerated at 28C and used within the recommended timeframe, with aliquoting advised to prevent peptide degradation from repeated freeze-thaw cycles.

While IGF-I remains the biomarker that best reflects endogenous GH secretion, when there is a discordancy with GH and IGF-I levels, it is important for the clinician to be mindful of the associated changes in intra-portal insulin delivery to the liver when interpreting these results in the context of health and when deciding treatment regimens in disease states

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The lack of monitoring means we cannot determine from existing clinical trial data whether semaglutide causes clinically significant b12 deficiency in typical patients