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Hypoglycaemia oral semaglutide alone does not typically cause low blood sugar, but if combined with insulin or sulphonylureas, hypoglycaemia risk increases and dose adjustments of the other medicines may be needed
There are two specific safety risks with compounded injectable GLP-1s that go beyond standard medication side effects, and both have been the subject of public regulatory and legal attention in 2025-2026
J Proteomics 126:8293 Datta R, Kumar D, Sultana A, Hazra S, Bhattacharyya D, Chattopadhyay S (2015) Glutathione regulates 1-aminocyclopropane-1-carboxylate synthase transcription via WRKY33 and 1-aminocyclopropane-1-carboxylate oxidase by modulating messenger RNA stability to induce ethylene synthesis during stress
Results from several of those studies are expected in the coming year
Compounded medications: Are prepared by licensed compounding pharmacies Are not FDA-approved brand products Require individualized dosing and close clinical monitoring In my practice, compounded GLP-1 medications are prescribed only when clinically appropriate, after a thorough discussion of risks, benefits, and alternatives
