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Arora says

Recent litigation updates reported 3,546 pending cases in April 2026, showing the docket was still expanding during that period

In the renal proximal tubule, GLP-1 reduced Na + /H + exchanger isoform 3 (NHE3)-mediated bicarbonate reabsorption [660]

As demand collides with coverage constraints, a growing out-of-pocket/cash-pay segment is emerging, where consumers effectively treat weight-loss pharmacotherapy as a discretionary wellness purchase: manufacturers and intermediaries are explicitly building self-pay pathways (e.g., LillyDirects self-pay programme

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Other contributing factors that could perhaps influence this relationship include the level of pre-existing retinopathy, initial hemoglobin A1c levels, duration of diabetes, cotreatment with insulin, and comorbidities