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However, emerging evidence suggests that incretin receptor agonists may also have direct effects on the activity of diseased synovial joint cells

Nasal-specific dosing considerations Factors affecting nasal absorption: Nasal congestion: Reduces absorption significantly Allergies: May impair uptake Sinus issues: Limits nasal route effectiveness Humidity: Dry air may reduce absorption Recent nosebleeds: Avoid until healed When nasal absorption compromised: Congested from cold/allergies: Skip dose or switch to injection Sinus infection: Avoid nasal route Chronic congestion: Nasal spray not ideal Deviated septum: May reduce one-side absorption Consider injection if nasal problematic Maximizing nasal absorption: Clear nasal passages first (blow nose gently) Use saline spray 10 minutes before (optional) Ensure proper head position Allow adequate absorption time Avoid nose blowing for 15 minutes after Stay hydrated Dose adjustment scenarios: Seasonal considerations: Winter: Dry air, congestion common (may need higher dose) Spring: Allergies may impair (switch to injection ) Summer/Fall: Usually optimal conditions Track seasonal patterns in response Nasal spray vs injection comparison Choosing the right administration route

During follow-up, transient or permanent insulin therapy may be required

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