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For some patients, returning to or optimising traditional oral agents such as metformin (if not already at maximum tolerated dose), sulphonylureas, or pioglitazone may be appropriate

Another contraindication is the use of GLP-1RA in patients with a history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2 (33, 34, 36)

Excessive caffeine also has the potential to lead to dehydration and may impact blood sugar levels

Furthermore, important observations that cirrhotic patients who appear clinically normal could also have defects on electroencephalography [3] and neuropsychometric testing [4] have led to the concept of minimal HE (mHE)