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There are a number of reasons for the frequent use of this therapy: from a pathophysiological point, the metformin/DPP-4 combination leads to higher GLP-1 concentrations compared to a therapy with a DPP-4 inhibitor alone (75)

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The relative risks of complications, including progression of CKD to end-stage kidney disease (ESKD), CVD and mortality, are increased with both reduced eGFR and elevated UACR levels [1]

These medications, while effective for weight management and blood sugar control, often come with digestive side effects that can be mitigated with proper fiber intake