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The efficacy of GLP-1RAs was compared with other antidiabetics in a network meta-analysis of 49 trials that included 3836 patients [59]

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Ozempic and Rybelsus are approved for type 2 diabetes, and Wegovy is primarily indicated for weight management in obese and overweight patients, when used along with healthy lifestyle modifications and caloric restrictions

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However, patients with polycythemia vera, Leber hereditary optic neuropathy, or certain cyanide-related metabolic conditions require careful medical evaluation before adding B12

In some cases, a long term B12 deficiency can be responsible for permanent neurological and nerve damage