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These include: Extreme fatigue Weakness Mood changes, including depression Memory problems Numbness or tingling in hands and feet High-Risk Groups Some groups face a higher risk of B12 deficiency

While the FDA-approved prescribing information does not list sexual dysfunction as a recognized side effect, some patients report changes in libido during treatment

DHvR has acted as a consultant and received honoraria from Boehringer Ingelheim and Eli Lilly, MSD, Novo Nordisk, and Sanofi and has received research operating funds from Boehringer Ingelheim-Eli Lilly Diabetes Alliance, MSD, AstraZeneca, and Novo Nordisk

A practical rotation approach includes spacing injections at least 12 cm apart within the same site and alternating between different sites each week