These changes collectively lead to adipose tissue dysfunction, characterized by increased release of inflammatory cytokines, enhanced lipolysis, impaired insulin signaling, and the development of leptin resistance, ultimately leading to the typical metabolic abnormal phenotype characteristic of PCOS (51, 5355)
This may be further pronounced in patients with diabetes with compromised gastrointestinal function due to autonomic neuropathy
Acute kidney injury (AKI) is a risk highlighted in FDA labels for these medications, particularly during episodes of severe dehydration from gastrointestinal symptoms
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It is also sometimes prescribed off-label for weight management