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[10] [11] This rapid metabolic shift can affect cardiovascular physiology, including heart rate variability and autonomic nervous system function

GLP-1 receptor agonists may be appropriate for individuals who: Have a body mass index (BMI) of 35 kg/m or higher (or lower thresholds32.5 kg/m or abovefor people from Black, Asian, and other minority ethnic groups) and would benefit from weight loss Have established cardiovascular disease or are at high cardiovascular risk (certain GLP-1 receptor agonists have demonstrated cardiovascular benefits in clinical trials) Have chronic kidney disease (CKD) or heart failure, where specific agents may offer additional protection Require additional glucose-lowering therapy but wish to avoid weight gain associated with some other diabetes medicines Cannot tolerate or have contraindications to other glucose-lowering therapies NICE NG28 continuation criteria : GLP-1 receptor agonist therapy should be continued beyond 6 months only if the person has had a beneficial metabolic response , defined as a reduction of at least 11 mmol/mol (1.0%) in HbA1c and a weight loss of at least 3% of initial body weight

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