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Accordingly, we encourage the adoption of GLP-1RA plus SGLT2i combination therapy in patients with T2DM and established atherosclerotic cardiovascular disease (ASCVD) or multiple risk factors for ASCVD (i.e., age 55 years, overweight/obesity, dyslipidemia, hypertension, current tobacco use, left ventricular hypertrophy, and/or proteinuria)

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Those impurities might include truncated peptide sequences, deletion variants missing one or more amino acids, oxidized forms of the peptide, or residual solvents from the synthesis process