In people with type 2 diabetes, higher hemoglobin A1c levels a record of blood sugar levels over two to three months were associated with less weight loss
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Who should not use semaglutide: Do not use semaglutide if you or any family member has ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

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Blood Cells Mol Dis 2018;70:54-65
It may not be fully effective if opened and not used within 8 hours