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The highest risk appears to be in patients with type 2 diabetes who have established diabetic retinopathy at the time of treatment initiation, particularly when aggressive glycemic targets are pursued rapidly without appropriate ophthalmologic monitoring

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Previous research Observational studies and meta-analyses of RCTs on fracture risk with GLP-1 RAs have found mostly neutral effects (50), although one meta-analysis found reduced risk of fractures ( However, studies on markers of bone health point towards direct beneficial effects of GLP-1 RAs on bone