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Table 1 illustrates that the most significant obstacles to progress across these systems have not been a lack of physiological relevance, but unresolved pharmacologic, technological, or conceptual challenges
As the FDA sorts through conflicting reports, Docs Diet, wants to help you avoid getting caught in the lurch

Sustainable performance gains come from smart training, consistent fueling tailored to your needs, adequate recovery, and maybe dialing in your bike fit not necessarily from a Gila monster-derived injection that might make you too nauseous to ride
C.FuA.ZhaoH.-L.et al (2013)
If your main question is tablet titration, Rybelsus Dosing Guide explains the step-up concept in more detail