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[9] [10] It works through multiple mechanisms: stimulating insulin secretion when blood glucose levels rise, suppressing glucagon release, slowing gastric emptying, and reducing appetite through effects on the brain

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DPP-4 inhibitors did not lower the risk of any cardiorenal outcome when compared with placebo and were associated with higher risks of MACE, HHF, and renal outcome when compared with the other two drug classes