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Worsening of diabetic retinopathy has been observed primarily with semaglutide during rapid glycemic improvement, particularly in patients with pre-existing retinopathy

There is also evidence to support that GLP-1 RAs favor bone formation by inhibiting RANKL-mediated osteoclast activation secondary to increasing OPG expression while simultaneously promoting osteogenic differentiation of bone mesenchymal stem cells and decreasing sclerostin expression, which in turn enhances Wnt/-catenin signaling, leading to bone formation (14)

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