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Practical strategies to minimize retinopathy risk during treatment initiation include: Gradual dose escalation following FDA-approved titration schedules Baseline ophthalmologic assessment before starting therapy in patients with known retinopathy More frequent monitoring during the first year of treatment in high-risk patients Coordinated care between endocrinology and ophthalmology specialists Patient education about vision changes requiring urgent evaluation Consider proactive reduction in insulin or sulfonylurea doses to reduce hypoglycemia risk during treatment intensification Patients should be counseled that while effective glucose control is essential for long-term eye health, any sudden vision changesincluding blurred vision, floaters, flashing lights, or vision losswarrant immediate ophthalmologic evaluation regardless of recent medication changes