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For weight management , NICE technology appraisal guidance supports semaglutide 2.4 mg (Wegovy) for adults with at least one weight-related comorbidity and a BMI 35 kg/m (or 30 kg/m in exceptional circumstances), as part of a specialist weight management service
Versus sulphonylureas (such as gliclazide), GLP-1 receptor agonists offer comparable glucose-lowering efficacy but with significantly lower hypoglycaemia risk and the advantage of weight loss rather than weight gain
The 29 gauge represents optimal balance between ease of insertion and flow rate, thinner needles (31 gauge) hurt less but inject more slowly, while thicker needles (27 gauge) inject faster but cause more tissue trauma
Most side effects, especially gastrointestinal symptoms, improve after the first few months
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