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A recent cross-sectional study involving 124 participants indicated that 56% of patients still exhibited elevated residual gastric contents despite halting incretin agonists for a minimum of 7 days, thus challenging the practice of discontinuing long-acting GLP-1 RAs solely for this duration prior to surgery [19]

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once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial

As ionic strength increases (adding salts), this repulsion is shielded, which in some cases can lead to increased aggregation or precipitation of the peptide (especially if the peptide has hydrophobic patches)

If you are experiencing consistent side effects at steady state (not just during the transition), that tells you the dose itself is probably too high for your tolerance, not that you are going through a temporary adjustment period