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However, more serious reactions have been reported, like pancreatitis, kidney problems, and an increased risk of diabetic retinopathy complications in those with a history of diabetic eye disease

doi: 10.1111/dom.12830

The discussion is best framed as a potential increased risk related to dehydration and rapid weight loss, balanced against the likely long-term benefits of improved metabolic health

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Renal Protection: Through tubulointerstitial fibrosis, podocyte damage, and glomerular endothelial dysfunction, oxidative stress and chronic inflammation also contribute to the progression of diabetic kidney disease