I have been getting dietary histories from patients for 20 years and educating them about insulin resistance as a strategy to minimize the need for medication to treat their autoimmune diseases. When compliance is high it is very effective especially for seronegative spondyloarthropathies, osteoarthritis and juvenile arthritis. So, I have no doubt GLP1 agonists will work as adjunctive therapy, but why are we skipping dietary studies to better understand the effects of insulin resistance on immune dysfunction and the benefits of ketosis on optimal immune function?