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Among them, 579,589 patients (15.1%) had been prescribed a GLP-1 RA: Dulaglutide: 6.6% Semaglutide: 4.9% Liraglutide: 4.2% Exenatide: 2.1% To control for disease severity, patients using only metformin or insulin were excluded from the primary reference group

Serious but Rare Side Effects: Severe liver injury (reported in less than 0.1% of patients) and kidney stones in some individuals

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Selenium has a narrow safe window, the NHS flags 350 g/day from supplements as the level unlikely to cause harm, and the UK Safe Upper Level is 450 g/day from all sources