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For example, persistent gastrointestinal symptoms leading to dehydration or a noticeable drop in eGFR or increase in UACR should prompt a temporary pause in medication

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Given that the glucose-lowering effect of metformin is so strong and is independent of incretin signalling, it might be difficult to detect the beneficial effect of metformin on the incretin axis in human studies

Quality and contamination concerns are important considerations

PMID: 23621381

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