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For older adults with cardiovascular risk factors, this benefit can tip the risk-benefit calculation meaningfully in favor of treatment
While it helps prevent blood sugar spikes after meals, metformin does not directly suppress appetite or trigger satiety signals in the brain

Some GLP-1 users, particularly those focused on high-protein, low-fat diets , inadvertently reduce fat intake to levels that contribute to constipation
A systematic review of the efficacy of domperidone for the treatment of diabetic gastroparesis

It is metabolically active at rest, contributing meaningfully to basal energy expenditure