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Participants provided informed consent and volunteered to participate in the research online, under a protocol approved by the external Association for the Accreditation of Human Research Protection Programs-accredited Salus Institutional Review Board ( Participants were included in the analysis on the basis of consent status verified at the time data analyses were initiated

All samples were evaporated to dryness and resuspended in 150 L of water/acetonitrile (ACN) (90:10, v/v) containing 0.5% FA

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Healthcare providers may consider: Bacterial culture if infection is suspected Temporary discontinuation of semaglutide to assess symptom resolution Referral to allergy/immunology for suspected hypersensitivity reactions For type 2 diabetes patients only, alternative GLP-1 receptor agonist formulations (such as oral semaglutide/Rybelsus) if injection site reactions are recurrent and problematic Patients with confirmed hypersensitivity to semaglutide should not continue the medication

These gastrointestinal side effects appear to be qualitatively similar to those reported in clinical studies of selective GLP-1 receptor agonists