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A 2022 systematic review and meta-analysis in JAMA Internal Medicine found increased rates of gallbladder or biliary disease among GLP-1 receptor agonist users compared to placebo or active comparators, with higher risk at weight-loss doses

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For patients who are unsure if GLP-1s are right for them, that lack of flexibility can make Hers feel like a gamble

For instance, a large network meta-analysis showed that SGLT-2 inhibitors reduced hospitalization for HF and renal composite outcome more than GLP-1RA [15], and that in patients with cardiovascular disease, SGLT-2 inhibitors show significant reduction in both heart failure (HF) hospitalizations and mortality for patients with HF and reduced ejection fraction [16]