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In PIONEER 4, oral semaglutide 14 mg once daily was compared with both liraglutide 1.8 mg and placebo in patients receiving metformin with or without a sodium-glucose cotransporter-2 inhibitor (SGLT2i) [8]

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Both of these side effects are mainly attributed to the impact of GLP-1 medications to slow down gastric emptying and cause gut distension (enlargement)

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