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Slower titration to avoid abrupt glycemic swings or lower maintenance doses in individuals at highest risk merit formal evaluation. Ong and Pasquel also underlined the need for strong synergy between diabetes care providers and ophthalmologists, as such collaborations may allow timely IRA dose adjustments rather than abrupt initiation or discontinuation, which itself may worsen cardiometabolic risk. The path forward is one of balance: preserve the broad advantages of IRAs and their successors while prospectively elucidating, stratifying and mitigating ocular risk, they concluded

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At nearly 5000 Da, it approaches the upper limit of what intranasal delivery can effectively handle