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Potential risks include: Enhanced gastrointestinal side effects (nausea, vomiting, diarrhea, constipation) Increased risk of nutritional deficiencies and protein malnutrition Potential worsening of gastroesophageal reflux symptoms Dehydration risk and acute kidney injury, particularly during dose escalation Increased risk of gallbladder disease and complications Risk of intestinal obstruction or ileus Diabetic retinopathy progression in patients with diabetes, particularly with rapid glycemic improvement Hypoglycemia risk, particularly in patients on insulin or sulfonylureas Cost considerations and insurance coverage challenges Rare but serious risks including pancreatitis and thyroid C-cell tumors (boxed warning) Clinicians must engage in shared decision-making with patients, carefully weighing these potential benefits against risks in the context of individual patient circumstances, surgical outcomes, comorbidities, and treatment goals

Screening on coumarin media led to the isolation of 10 bacterial strains, including species of Bacillus , Pseudomonas , Enterococcus , and Stenotrophomonas

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A more accurate way to measure obesity in claims data

Some clinical studies have shown detrimental effects of DPP-4 inhibitors on bone [13, 16, 18], with one study showing no effects [110]

Oct 15 2009;78(8):951-958