Abstract Purpose A patient was identified with severe metabolic acidosis, a high anion gap and 5-oxoproline accumulation, probably caused by the simultaneous use of paracetamol (acetaminophen) and flucloxacillin
Patients carrying variants associated with lower GLP-1 receptor sensitivity may benefit from provider conversations about dose escalation timelines, while those with variants linked to robust appetite suppression may achieve meaningful results on low-dose therapy
Incretin-only mechanism studies: If the objective is to isolate GIP + GLP-1 effects without glucagon-receptor confounding, tirzepatide is the cleaner reference compound
It is likely that the gastrointestinal adverse effects of GLP-1 RAs can contribute to the development of CI by the induction of constipation and volume depletion, the latter of which can result in systemic hypotension which is a known risk factor of CI
By contrast, routine initiation is generally not indicated for lean PCOS or for patients with low cardiometabolic risk, except in selected circumstances (e.g., specific metabolic indications) or within research protocols