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This biological compatibility explains why patients can use GLP-1 class medications for years without needing dose increases beyond the initial titration period

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These mechanisms occur within hours after GCs administration and may lead to hyperglycemia, even in individuals without a prior history of glucose abnormalities ( Figure 1 The clinical impact of hyperglycemia during GCs therapy has been well established, with multiple studies reporting increased morbidity and mortality, including higher rates of infection, cardiovascular events and prolonged hospitalisations ( Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are not currently recommended in SID by major guidelines, their mechanism of action makes them promising candidates to counteract the metabolic impacts of steroids