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Abbreviations EMR: Electronic medical record ETDRS: Early Treatment Diabetic Retinopathy Study EWDR: Early worsening of diabetic retinopathy GIP: Gastric inhibitory polypeptide GLP-1RA: Glucagon-like peptide-1 receptor agonist ICLDC: Imperial College London Diabetes Centre MAP: Mean arterial pressure MBS: Metabolic bariatric surgery NPDR: Non-proliferative diabetic retinopathy PDR: Proliferative diabetic retinopathy PSM: Propensity score matching SGLT2i: Sodiumglucose cotransporter 2 inhibitor References Feldman-Billard S, Larger , Massin P, for the Standards for screening, surveillance of ocular complications in people with diabetes SFD study group (2018) Early worsening of diabetic retinopathy after rapid improvement of blood glucose control in patients with diabetes

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Practical considerations for patients When considering tirzepatide, whether under the brand name Mounjaro or Zepbound, patients should take into account several practical considerations to ensure safe and effective use: Administration and monitoring: Dosage : Begin with a usual initiation dose of 5 mg/0.5 mL injected subcutaneously once a week for Mounjaro and once every two weeks for Zepbound Monitoring : Schedule regular follow-ups to monitor hemoglobin A1c and body weight, adjusting the treatment plan as necessary Blood sugar levels : Maintain regular monitoring of blood sugar levels, especially crucial for those with type 2 diabetes Precautions and safety measures: Pregnancy : Use tirzepatide only if the potential benefit outweighs the risk to the fetus