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GLP-1 RAs should be avoided in patients with severe gastroparesis or inflammatory bowel disorders [24]

Baggio et al., Plasma levels of DPP4 activity and sDPP4 are dissociated from inflammation in mice and humans, Nat

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These are reference parameters - the treating clinician makes the determination based on the complete medical picture, not a self-reported BMI on an intake form

For patients and clinicians, this was a novel mechanism a drug for diabetes that caused weight loss and had low hypo risk was almost unheard of at the time