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Serious but less common adverse effects include pancreatitis, gallbladder disease, acute kidney injury (particularly in the setting of dehydration from gastrointestinal symptoms), and hypoglycemia when used in combination with insulin or sulfonylureas

USP Convention, 2023

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Although it seems this bidirectional connection is guided by various mechanisms, there is no definitive epidemiological evidence linking gut dysbiosis, the CNS, and the peripheral immune system (see Fig

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