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Government figures show Medicaid spending on these drugs jumping from roughly $600 million in 2019 to nearly $4 billion within a few years, even as the number of states covering them for obesity has fallen

Notably, SGLT-2is induce natriuresis and osmotic diuresis, causing a contraction in plasma volume, reduction in blood pressure, and improvement in cardiac preload and afterload [6, 28]

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