Dr.KarenChen said:

The trials generally allowed a step to be held or reduced and then retried, and people who did that mostly arrived at the same place a few weeks…

No disagreement, though the timescale matters more than the mechanism here. Most of what looks like a difference in kind turns out to be a difference in how long somebody waited.

Correct me if the detail matters more than I have assumed.

KarenAZ_mom said:

The glucagon component looks paradoxical and is not.

This is exactly what I could not find anywhere else. Taking it to my next appointment.

Dr.KarenChen said:

The trials generally allowed a step to be held or reduced and then retried, and people who did that mostly arrived at the same place a few weeks…

I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.

Adding the numbers, since they settle part of this. Practical: whatever you change, write down the date and the reason. In three months the reason is what you will have forgotten, and the reason is what makes the record worth having.

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. Tagging this one for the weekly digest.