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Mechanical agitation can cause peptide aggregation and foaming

The oral semaglutide results were slightly better than what appeared in the PIONEER trials (1.8% average reduction versus 1.1%), while the injectable results were comparable to the SUSTAIN trials (1.4% versus 1.56%).[1] The weight loss results from this real-world study were somewhat better than clinical trials, which researchers attribute to the higher baseline weight in their patient population (average 106.9 kg versus 88-92 kg in trials) and concurrent use of other medications that contribute to weight loss.[1] Study Strengths and Limitations The study's main strength is that it reflects actual clinical practice

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A significant crest and furrows were noticed on intermediate spaces of the tissues