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Berberine doesnt typically cause serious side effects, so even though its recommended to take it when eating, you can take it on an empty stomach

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10.1073/pnas.0711752105

Notably, one study included in the meta-analysis, with a follow-up period of at least 2 years, showed that GLP-1 RAs were associated with a lower risk of MAKEs, and protocol biopsies results indicated that GLP-1 RAs may promote tubular cell regeneration in the kidney graft [59]