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renal dosing adjustments required Thiazolidinediones (pioglitazone): Insulin sensitizer

Most heart and metabolic gains are gone within 1.4 years

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identified increased relative abundances of Megasphaera , Veillonella , Escherichia-Shigella , Anaerostipes , and Haemophilus as potential microbial indicators of DKD [124]

Ozempic may contribute to an increased risk for thyroid c-cell tumors, acute pancreatitis, gallbladder disease, hypoglyceia, acute kidney injury, severe GI side effects, and an increased risk for worsening of diabetic retinopathy in people with type 2 diabetes