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It targets both the GLP-1 and GIP receptors

Although diabetes incidence showed only a modest increase in all mice, the study found a significant acceleration of T1D onset in females and an increase in insulitis in males (114)

The inflammation question is more nuanced

Rybelsus must be taken on an empty stomach with up to 120 ml water, with at least 30 minutes before food or other medicines, which affects timing of berberine administration