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(This study examines the effects of semaglutide on glycemic control and other metabolic parameters, including potential side effects such as dehydration.) Davies MJ, Bergenstal R, Bode B, et al

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5.4 Acute Renal Failure There have been postmarketing reports of worsening renal function in patients taking sitagliptin with or without metformin, including acute renal failure, sometimes requiring dialysis

If the injection site hurts, it could be from injecting the medication while it is cold consider allowing your medication to come to room temperature before the injection