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Beyond its metabolic and anti-inflammatory effects, recent evidence highlights the importance of sex as a biological variable in determining the response to VLEKT
Most people manage this by trial and error, which is familiar and simple, but it scatters evidence across sticky notes, memory, and half-remembered meals
The aging gut faces multiple challenges: Reduced bacterial diversity - fewer species means less metabolic flexibility Decreased butyrate producers - particularly Faecalibacterium prausnitzii and Roseburia species Slower transit time - affecting fermentation patterns Changes in digestive secretions - impacting bacterial growth conditions Medication effects - many common medications affect gut bacteria These changes create a cycle where reduced butyrate production may be linked with increased intestinal permeability, low-grade inflammation, and further microbiome changes
Paradoxically, very low calcium diets can increase oxalate absorption and stone formation
Therefore, T2D management should emphasize promotion and maintenance of gut health
The combination of sitagliptin and metformin is indicated in patients who are not adequately controlled on metformin or sitagliptin alone or in patients already taking both agents
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