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While GLP-1 agonists alone have a low intrinsic risk of causing low blood sugar, this risk increases significantly when they are used in combination with insulin or sulphonylureas, as noted in product SmPCs [11] [9] Possibly associated with rapid weight loss : Significant weight reduction might potentially lead to electrolyte imbalances or nutritional deficiencies that could contribute to tremor, though this mechanism is not well-established Coincidental : Tremors may develop independently of medication use, particularly in older adults or those with other underlying conditions If you develop new or worsening hand tremors whilst taking a GLP-1 agonist, it is essential to discuss this with your healthcare provider rather than assuming a direct causal relationship