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[33] In addition, symptom severity may not correspond to the extent of delayed gastric emptying as measured by scintigraphy

If your kidney function declines during treatment, your metformin dose may need adjustment, but this is managed as part of your regular clinical follow-up

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Most clinicians would advise that if you are achieving satisfactory results with Wegovy alone, there may be limited justification for adding berberine, particularly given the potential for increased side effects and the lack of robust clinical evidence supporting additive benefits