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Morning grogginess: most research write-ups describe shifting the dose earlier in the evening before lowering the dose itself

We also mentioned less common causes like tears in the esophagus and a specific type of lesion

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Figure from van der Aart-van der Beek AB, Nat Rev Nephrol, 2020 The Study Methods This was an international, event-driven, double-blind, parallel-group, randomized, placebo-controlled trial conducted at 387 sites in 28 countries comparing semaglutide to placebo in patients with T2DM and CKD, both being treated with baseline standard of care