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Micronutrient deficiency

Furthermore, it has been reported that the administration of exenatide attenuates the renal inflammation index, including reducing the TNF-, IL-6, hsCRP, and CCL5 levels, in STZ-induced diabetic rats by increasing the superoxide dismutase and decreasing malondialdehyde levels (Wang et al., 2019)

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Primary indication is diabetes management based on blood glucose criteria, not BMI

So, on balance, the side effects of using these drugs are felt to be outweighed by the side benefits of losing weight