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One important unresolved issue is the limited evidence regarding concomitant use of SGLT2 inhibitors and GLP-1 receptor agonists, a gap also acknowledged in European Society of Cardiology guidelines and Current guidelines prioritize SGLT2 inhibitors in patients with T2DM who have HF, chronic kidney disease, or elevated cardiovascular risk, while GLP-1 receptor agonists are emphasized for patients with obesity or established atherosclerotic cardiovascular disease [7]

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Also, clinical observations of the Second Meal Effect show that these fibers improve glucose tolerance and quiet food noise not just for the current meal, but for the following one as well

It is also a Schedule II controlled substance that carries a significant risk of dependence and addiction