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GLP-1 medications include semaglutide, dulaglutide, and liraglutide, used for type 2 diabetes and weight management Common gastrointestinal effects (nausea, vomiting, diarrhoea) can lead to fluid loss and electrolyte depletion affecting muscle function Maintaining adequate hydration (1.52 litres daily) and dietary electrolyte intake may help prevent cramping Concurrent medications such as diuretics, SGLT2 inhibitors, and statins may contribute to muscle-related symptoms Persistent, severe, or frequent cramps warrant medical review to assess electrolytes, renal function, and exclude other causes Table of Contents What Are GLP-1 Medications and How Do They Work

Athletes subject to anti-doping rules should be aware of the current regulatory landscape in their sport

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doi: 10.1136/bmj.d6898 13 MonamiMCandidoRPintaudiBTargherGMannucciEof the SID-AMD joint panel for Italian Guidelines on Treatment of Type 2 Diabetes