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The most important effect of GLP-1 is to increase insulin secretion after a meal, and this effect is dependent on glucose concentration, so despite promoting insulin secretion, the occurrence of hypoglycemia is rare [25]
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Furthermore, as SGLT2 inhibitors are not currently licensed in the UK for reduction of cardiovascular risk when glucose is at target, people will also need to be counselled about off-licence use
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It also notes that a history of diabetic retinopathy, severe kidney disease, or concurrent insulin use may push a provider toward alternative agents entirely
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