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doi: 10.2337/db16-1344

a direct causal link in humans has not been established, and current EU and UK summaries of product characteristics (SmPCs) for approved GLP-1-based therapies do not list this as a formal contraindication, though it remains a theoretical concern warranting caution People with severe gastrointestinal conditions , such as gastroparesis or inflammatory bowel disease Those with a history of pancreatitis , which has been associated with GLP-1 receptor agonist use Children and young people under 18 , who have not been studied in retatrutide trials to date People with a history of gallbladder disease or gallstones , given the known association between this drug class and gallbladder events Those with proliferative diabetic retinopathy or macular oedema , where rapid improvements in blood glucose control may carry additional risks People with severe renal or hepatic impairment , pending further safety data Age-related eligibility, renal function, hepatic status, and existing medications would all need to be carefully assessed by a qualified clinician before any treatment decision could be made

Indirect factors such as nocturnal hypoglycaemia, gastrointestinal discomfort, or concurrent medications may influence sleep quality

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