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DPP-4 inhibitors may be a treatment option for patients in whom metformin is contraindicated due to decreased renal function or intolerable gastrointestinal side effects

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However, its metabolic conversion by gut microbiota into TMAO raises significant concerns due to the association of elevated TMAO levels with cardiovascular diseases like atherosclerosis, MI, stroke, and HF

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After having been chewed to bits, meals are first broken down with the help of acid in the stomach, and bile and enzymes in the small intestine

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