"Reclaiming the Narrative" of Sexual Violence Disclosures on Social Media: Social Reactions, Gender Norms, and Recovery.

Physical activity as well as fasting periods—overnight, for procedures or hospitalisations, as part of a dietary pattern, or for religious purposes—are well‐recognised triggers of hypoglycaemia in people with type 2 diabetes (T2D), especially in those treated with insulin [, , , ]. Exercise increases skeletal muscle glucose uptake and insulin sensitivity, effects that may persist for hours and increase the risk of delayed hypoglycaemia [, ]. Prolonged fasting reduces hepatic glucose production and exogenous carbohydrate availability, further predisposing insulin‐treated individuals to low blood glucose []. These mechanisms remain clinically relevant despite advances in insulin formulations and glucose monitoring [, ]. Current consensus statements therefore recommend careful planning, glucose monitoring and, when feasible, insulin dose adjustments around exercise to mitigate hypoglycaemia risk [, ]. Icodec is a once‐weekly basal insulin engineered to achieve strong, reversible albumin binding and reduced insulin receptor affinity, resulting in a prolonged half‐life and a glucose‐lowering effect profile suitable for once‐weekly administration [, , ]. In the ONWARDS phase 3 clinical trial programme, icodec provided glycaemic control superior or similar to once‐daily basal insulins with generally low risk of clinically significant hypoglycaemia across diverse T2D populations, including insulin‐naïve individuals and those previously treated with basal or basal‐bolus regimens [, , , , , ]. The prolonged action of once‐weekly insulin raises specific clinical considerations. Unlike daily basal insulin, dose adjustments in anticipation of spontaneous exercise or fasting periods are not feasible, potentially increasing concern about hypoglycaemia during altered insulin sensitivity or reduced carbohydrate intake. A post hoc analysis of ONWARDS trials in T2D suggested that icodec was not associated with increased physical activity‐related hypoglycaemia versus daily basal insulin []. Nonetheless, prospective studies specifically designed to evaluate exercise‐induced hypoglycaemia risk in people with T2D treated with icodec under standardised and closely monitored conditions are lacking. Post hoc analysis of ONWARDS trials also suggested stable glycaemic control with low rates of clinically significant or severe hypoglycaemia during hospitalisation among individuals with T2D receiving icodec or once‐daily comparators []. Still, the direct impact of prolonged fasting on glucose levels and hypoglycaemia risk with icodec treatment in individuals with T2D has not been formally investigated.