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Our current practice is to consider a ~20% bolus insulin decrease and a ~10% basal insulin decrease before GLP-1RA initiation, although prior A1c, risk of hypoglycemia, potential risk of ketosis due to reduced insulin doses, as well as other patient-specific factors should guide the final insulin dose changes

These typically emerge in the first two to four weeks and improve as the body adapts

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- to the intravenous injection route: