I'll just mention two issues
Combination therapies Combination therapy with SGLT2 inhibitors and GLP-1 receptor agonists offers a promising approach to enhance cardiovascular and kidney protection in people with type 2 diabetes mellitus, particularly those at high risk [9,20]
Acta 333 , 1939 (2003)
hypothesized that in obesity-related insulin resistance (IR), skeletal muscle may decrease FAO because of decreased CACT activity 58
The most commonly reported complications include: Intestinal obstruction, where the normal movement of food and waste through the intestines becomes blocked Gastroparesis (stomach paralysis), a condition in which the stomach slows or stops emptying food into the small intestine Ileus, a condition in which the bowel temporarily stops functioning Severe or prolonged constipation that does not respond to routine treatment Bowel perforation or colon rupture, sometimes occurring without obvious warning symptoms Other gastrointestinal complications, such as extreme vomiting leading to dehydration or hospitalization Sepsis, a life-threatening infection that can follow intestinal injury Some patients allege that intestinal blockages progressed quietly, without clear early symptoms, until they became a medical emergency requiring urgent surgery
It cannot be legally purchased without a medical consultation