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No effects were seen when glucose was not administered, compatible with the idea that DPP-4 inhibition exerts an anti-hyperglycaemic effect by preventing degradation of endogenously released GLP-1 (26), subsequent studies in glucose-intolerant rodent models did show that the improved glycaemic control following in vivo DPP-4 inhibition was associated with enhanced intact GLP-1 responses to glucose challenges (2729)

This lab-verified approach helps reduce audit risk and supports long-term compliance with evolving pharmaceutical guidelines

Given the observational and exploratory nature of this study, no formal adjustment for multiplicity was applied to the secondary or exploratory outcomes

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