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The American Diabetes Association Standards of Care acknowledge gastrointestinal tolerability as a key consideration when initiating GLP-1 receptor agonist therapy, recommending gradual dose titration to minimize these effects

Clinicians avoid combining therapy with dipeptidyl peptidase-4 inhibitors due to minimal glycemic benefits and increased hypoglycemic risk (30)

Clinical Update 5/12/2026 Caution With GLP-1s and Lithium Starting or switching GLP-1s while on lithium may cause serious side effects, according to several reports

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