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These findings are concordant with those of observational studies that have also observed a decreased risk of major adverse cardiovascular events when comparing the GLP-1 receptor agonist-SGLT-2 inhibitor combination with different types of comparators: sulfonylurea-GLP-1 receptor agonist combination (hazard ratio 0.67, 0.59 to 0.89),30 metformin-sulfonylurea combination (hazard ratio 0.53, 0.35 to 0.80),31 and other combination regimens (odds ratio 0.70, 0.50 to 0.98).19 As these studies compared the GLP-1 receptor agonist-SGLT2 inhibitor combination with other drug combinations, they were designed to answer different clinical questions.193031 By contrast, our study was specifically designed to determine whether the add-on of a GLP-1 receptor agonist or an SGLT-2 inhibitor versus either drug class alone results in additional benefits on cardiovascular and renal outcomes
A 2025 Diabetes Care commentary describes physicians using multidose pens for fractional micro-titration below the FDA-approved starting dose specifically for GI tolerability (Kom et al., 2025)
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Removing the needle too early can result in medication leaking out of the injection site, which means you receive less than the intended dose
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