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Frias JP, Bonora E, Ruiz LN et al (2021) Efficacy and safety of dulaglutide 3.0 mg and 4.5 mg versus dulaglutide 1.5 mg in metformin-treated patients with type 2 diabetes in a randomized controlled trial (AWARD-11)

The clinical question is what to do about it: dose adjustment, titration change, lifestyle review, or sometimes a switch to a different molecule

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Such hyper-inflammatory state could lead to loss of appetite, altered intestinal absorption, impaired gut permeability, and malnutrition 683,684

Tretinoin is best used at night to minimize sun sensitivity