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Some metabolically flexible individuals can maintain ketosis at up to 50 grams, but in the context of semaglutide-driven caloric restriction, erring toward the lower end is advisable
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26 For individuals with T2D and CVD/high risk for CVD with mild to moderate residual hyperglycemia (eg, A1C 30% after initiation of a RASi or MRA, other causes of these abnormalities should be evaluated (eg, volume depletion, NSAID use, interaction with other drugs that affect circulating volume or intrarenal hemodynamics), and medication adjustments should be considered (eg, dose reduction or discontinuation of the drug or changes to concomitant medications or volume management), with subsequent additional monitoring
have a history of pancreatitis or thyroid cancer
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