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The MHRA Drug Safety Update (2019) has highlighted rare reports of diabetic ketoacidosis (DKA) in patients treated with GLP-1 receptor agonists, particularly when insulin is rapidly reduced or discontinued

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(Reference Gayatri, Kumar and Kumar28) , participants were not randomly assigned to the intervention and control groups, and seven studies described an allocation concealment method (Reference Hassan, Alalfy and Hassan18,Reference Badawy, El Nashar and El Totongy20Reference Hashim, Anwar and El-Fatah22,Reference Elgindy, El-Huseiny and Mostafa23,Reference Ghomian, Khadem and Moeindarbari5,Reference Maged, Elsawah and Abdelhafez8)