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People with severe kidney disease (eGFR below 30) People with serious liver disease Before surgery or contrast dye procedures doctor will temporarily stop it References: Metformin StatPearls, NIH Bookshelf Metformin: Update on Mechanisms of Action Nature Reviews Endocrinology Metformin Action in the GI Tract Frontiers in Pharmacology 2024 GLP-1 Receptor Agonists Ozempic, Trulicity, Victoza Explained You may have seen Ozempic trending on social media recently celebrities using it for weight loss, news articles calling it a miracle drug. But what exactly is it

Clinician-framed advice therefore, includes slower titration, medication review, and tailored behavioral strategies to reduce triggers and allow adaptation