GLP-1 receptor agonists and SGLT2 inhibitors in type 2 diabetes: pleiotropic cardiometabolic effects and add-on value of a combined therapy
The triple-agonist concept (GLP-1 + GIP + glucagon) GLP-1 (glucagon-like peptide-1): This is the pathway targeted by semaglutide (Wegovy, Ozempic)
Robert Ziltzer are board-certified in Obesity Medicine and have been consistently named Top Doctors by Phoenix Magazine
Other research highlights: 30% of GLP-1 users tested positive for SIBO or IMO even after accounting for diabetes (5) GLP-1 medicines caused microbiome changes and altered metabolism in mice (6) GLP-1 medicines tested in humans only had noticeable microbiome changes by 48 weeks (7) Despite not necessarily having slower gut motility, one study found that 88.9% of obese patients had SIBO (8) A meta analysis of people with IBS symptoms, found that up to 78% of people had SIBO, many of whom were undiagnosed (9) Overall, Sun and colleagues (1) could not prove a mechanistic link between GLP-1 medications and SIBO, however they did find that SIBO was twice as likely in GLP-1 users
doi: 10.1007/s11064-026-04758-y 38 ZhengX.WangH.LiuP.PanJ.LvR.FengC
Beyond protein, lower food intake can also make it harder to get enough B vitamins, vitamin D, magnesium, zinc, and other key nutrients that support energy production, muscle function, and recovery
