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Message: <blockquote data-quote="Oldvatr" data-source="post: 2569514" data-attributes="member: 196898">From what I can see from the DKA reports linked to these medications the suspected events are actually due to a transient insulin deficiency that may occur shortly after starting treatment when glucose levels are low.  This is thought to be where a low carb diet has been used to reduce hyperinsulinemia at the start of treatment, and the sudden improvement / demand can tip things over,  It is an increased risk factor for these meds, and occurs mainly in the other forms of the med (liriglutide, extenide etc) so the makers of Ozempic are able to claim no problems with Semaglutide but this med is being monitored.  Looking at how the meds work, the presence of a strong GLP-1 demand will empty the pancreas granules, so lowering insulin output   Normally our bodies produce GLP-1 in response to eating, so is cyclic in nature, allowing the pancreas to charge up the granule storage for the Phase #1 insulin response. Instead, the pancreas is running at full tilt which is why the advice is to eat carbs while on this medication.</blockquote>

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