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Semaglutide works by slowing stomach emptying and signaling fullness to the brain, while metformin improves insulin sensitivity and reduces liver glucose production

this offsets about 9 kg of an expected glucosuria-induced bodyweight loss of 11 kg over 2 years [77]

Since ESSENCE was designed to evaluate semaglutide in participants with underlying liver disease, hepatic function tests were measured every 12 weeks, and criteria were established for discontinuation in participants with an increase in pre-specified changes in ALT, AST, total bilirubin, or INR (Supplemental Table S1, Among the 538 participants receiving semaglutide, none stopped it because of elevated ALT or AST

Tracking is provided for every shipment, and shipments are insured for lost packages (except when incorrect shipping information was provided)

Gastrointestinal side effects were mild to moderate, and no patients stopped treatment due to tolerability issues

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