Injection site reactions, including bruising, are documented adverse effects in semaglutide clinical trials, though bruising is not separately reported in FDA labeling
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Moreover, Griffioen et al 151 reported that GLP-1R activation suppressed HR variability, and this effect was supported by the findings of the inhibition on release of both excitatory glutamatergic and inhibitory glycinergic neurotransmitters to the preganglionic parasympathetic cardiac vagal neurons
When insulin/GLP-1RA fixed-ratio combinations are compared with basal insulin, a superiority in reducing HbA1c is observed, with overall benefit also in weight neutrality or weight loss, reduced hypoglycemia risk, and reduced insulin-dose requirement [19, 25,26,27, 30, 31]
Other rare but serious complications include infection at the injection site (abscess formation) and, in isolated reports, neurological effects