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In patients with diabetes, GLP1 RA initiation was also associated with a lower risk of requiring additional glucoselowering therapy, but no difference in the risk of nonadherence, compared to metformin initiation

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At the same time, it is important to acknowledge the limitations of pivotal trials such as STEP and SELECT, whose generalisability is constrained by relatively short follow-up, notable dropout rates, and the predominance of Western cohorts