semaglutide injections nc Tirzepatide vs Weight-Loss Drugs Dropped in North

Finally, some of the included studies in this meta-analysis did not take weight change as the primary outcome, and some data were extracted from the appendix or from the Clinicaltrials.gov website, which may introduce potential inconsistencies

Rare but more serious concerns include pancreatitis and potential worsening of gastroparesis

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In contrast, acute hypoglycemia has been associated with increased gastric emptying.27,28 Changes in gastric emptying associated with acute dysglycemia have been proposed as an additional form of glucose regulation, in which glucose absorption is increased or reduced, as a counterregulatory response, according to glucose requirements.24 Dysbiosis and bacterial overgrowth Another of the manifestations associated with diabetic gastrointestinal neuropathy is the slowing down of intestinal transit, propitiating the intestinal bacterial overgrowth that favors intestinal malabsorption and chronic diarrhea.15 In addition to neuropathy, there are other factors that have been associated with bacterial overgrowth in patients with diabetes, among which are reduced pancreatic exocrine function, as well as chronic opioid use.29,30 Use of artificial sweeteners Despite the fact that artificial sweeteners as an alternative to sugar appeared to be an adequate strategy for glycemic control and reduced calorie intake, in recent years, their use has been linked to undesirable metabolic effects, including gastrointestinal effects.31 Intestinal motility alterations and changes in the gut microbiota have been more frequently reported through experimental models but results in clinical trial results have not been conclusive.32 Psychologic dysfunction The psychologic disorders of anxiety and depression have been reported to be highly prevalent in patients with diabetes.17 In turn, those same psychologic comorbidities are strongly associated with gastrointestinal symptoms, increasing their appearance and perception.33 Elevated levels of anxiety, depression, and neurosis have previously been described to be directly related to gastrointestinal symptoms in patients with diabetes, suggesting an additional nonorganic factor of gastrointestinal dysfunction associated with diabetes.34,35 Antidiabetic pharmacologic generalities It is important to remember the pharmacologic classification of antidiabetics and recognize that some of them have gastrointestinal effects, such as the biguanides, alpha-glucosidase inhibitors, and GLP-1 analogues (Fig