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The addition of DPP-4 inhibitors to patients already treated with metformin may seem particularly attractive, since both drugs may act to enhance circulating levels of GLP-1 and thus, may have synergistic effects on incretin receptor signaling [44,45,46]

Adequate hydration helps maintain healthy mucosal linings, facilitates digestion, and supports the elimination of hormone metabolites via bowel movements

The immune system becomes hyper-vigilant and metabolically demanding, hoarding the body's limited ATP reserves