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Insulin Dose Reduction at GLP-1 RA Initiation In the SUSTAIN-5 trial (N=397), patients on semaglutide 1 mg plus basal insulin experienced a symptomatic hypoglycemia rate of 11.3%, versus 1.1% in the semaglutide-plus-metformin-only arm [6]

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Neutralizing IL-1 or IL-18 (the inflammasome products) is another approach: Anakinra (IL-1 receptor antagonist) has been used off-label in systemic inflammation settings and is attractive for short-term use around surgery to DAMPsen the IL-1 surge (115)

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