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The widespread use of selective DPP4 inhibitors for the treatment of type 2 diabetes has heightened interest in the molecular mechanisms through which DPP4 inhibitors exert their pleiotropic actions

Interestingly, GLP-1RA has been proven to potentially modulate the intestinal environment and is linked to alterations in gut microbiota [19]

Consistent with these findings, clinical observations in CKD cohorts have demonstrated a positive correlation between serum levels of IL-6/IL-1 and markers of erythrocyte membrane damage (e.g., increased osmotic fragility), as well as an inverse correlation with eryptosis (Mehta et al., 2017)

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According to SemaPen and the Cheshire Formulary, this combination could actually create a high risk for a crash blood sugar level