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Stromberg, Z
Skipping meals or drastically reducing carbs without adjusting insulin can trigger hypoglycemia
Although strict glycemic control has beneficial effects on microvascular complications (retinopathy, nephropathy or neuropathy), it does not seem to reduce the risk of cardiovascular disease, and it is associated with an increased risk of hypoglycemia in patients with DM2.3,6 Until recently, the antihyperglycemic drugs available have improved glycemic control, but without much benefits on cardiovascular and/or renal risk
Efficacy may be somewhat lower than injectable semaglutide at equivalent doses, but patient adherence can be higher due to the oral route
Choose based on primary goal If your primary goal is visceral fat reduction specifically, tesamorelin has the strongest evidence
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