Dose escalation: be bold?

Hong Kong Yanpep International
I'm T2D and my goal is the smallest dose that holds my A1C where it should be. That way, if my glucose climbs, there's room left to increase. With your glucose looking good, I'd stay put, though that's only my view. Bear in mind a higher dose might bring stronger side effects.
 
Forum talk and the trial results are often pretty different. Around here it's mostly the smallest dose that does the job, for losing and for keeping it off. That cuts side effects but also caps the benefits, and it leads to constant posts asking why a tiny dose isn't cutting it. I think the evidence backs sticking with the dose you lost on. Long follow-ups of sema and tirz held weight steady as long as 4 years on the same dose, no drift in either direction until the trial ended and the drug stopped, and then it came back fast. Had the dose been too high, people would've kept losing, too low and they'd have gained, and neither happened. That's strong proof from big well-run trials, so the maintenance dose is just the weight loss dose.
 
People respond very differently to GLP drugs, in both side effects and benefits. Starting below the standard dose reduces the risk of sudden unpleasant side effects. Somebody may feel slight nausea at 8mg while somebody else throws up at 2mg, but standard starting doses exist for a reason, since they make severe reactions unlikely. Two weeks on 1mg first is sensible though optional, and going lower than that probably wastes time for most people. Those who carry little or no excess weight can respond strongly to small doses. In that case small steps upward are logical, chiefly because the drug's health risks aren't offset by the benefits of treating their weight.
 
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