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Patients may need a more careful discussion if they have a history of: Previous NAION in one eye Significant optic nerve crowding Diabetes with vascular complications Sleep apnea, especially untreated sleep apnea High blood pressure or low nighttime blood pressure Cardiovascular disease Sudden unexplained vision loss in the past This does not automatically mean a GLP-1 medication is unsafe, but it does mean the patient should have a personalized risk-benefit discussion with their medical provider

Understanding why these changes occur, what to expect, and when symptoms require medical attention helps patients manage treatment effectively whilst maintaining therapeutic benefits

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Alternatively, if the elevated anion gap persists despite cessation of acetaminophen and administration of N-acetylcysteine, pyroglutamic acidosis is unlikely, and an alternative diagnosis should be sought

Mnchen, 02.05.2008

Garca Puig, J