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ACC American College of Cardiology, AHA American Heart Association, ESC European Society of Cardiology, ADA American Diabetes Association, GLP-1 RA glucagon-like peptide 1 receptor agonists, T2DM type 2 diabetes mellitus, ASCVD atherosclerotic cardiovascular disease, CV cardiovascular, CVD cardiovascular disease, MACE major adverse cardiovascular event, SGLT2i sodium-glucose co-transporter 2 inhibitors, BMI body mass index, MI myocardial infarction, HFpEF heart failure with preserved ejection fraction a ACC/AHA and ESC utilize class of recommendation (1, 2a, 2b, 3) which highlights the overall benefit of a treatment compared to its risks

The ketogenic diet typically requires limiting carbohydrates to 20-50 grams daily, which forces metabolic adaptation within days

Furthermore, adverse events are rare, except for nausea and vomiting during the initial phase of therapy, and are similar between the GLP-1 receptor agonists [3]

To ease discomfort, apply ice for 10 to 15 minutes in the first 24 hours to reduce swelling, then switch to heat to promote blood reabsorption

Slower stomach emptying changes portion tolerance GLP1 medications slow gastric emptying, which helps you feel full sooner and stay full longer

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