Not surprisingly, results from several studies have shown that initial combination therapy with metformin and a DPP-4 inhibitor provides greater improvement in glycemic control than monotherapy with either agent [14, 18,19,20]
Visual inspection of the funnel plot (Supplementary Figure 2) revealed symmetrical study distribution, suggesting minimal likelihood of publication bias or between-study systematic bias
However, this remains controversial as histological findings are inconsistent, and there is no definitive link established between GLP-1 and nesidioblastosis
After that, the predominant remaining effect is appetite suppression, which is the intended therapeutic outcome
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