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In some cases, it can get worse if blood sugar improves too quickly

Type 2 diabetes in adults: management, NICE guideline NG28

DOI: 10.1016/S0140-6736(22)02033-5

This initial phase occurs while you remain on the lowest maintenance doseusually 0.25 mgwhich allows your gastrointestinal system time to acclimate to the medication without overwhelming nausea or side effects
