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Precautions: Metformin and sitagliptin are excreted mainly by the kidneys

If your diarrhea is accompanied by severe pain that is different in character from typical GI cramping, particularly pain that radiates to your back or worsens after eating, seek emergency medical attention

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This is called tolerance

Restricting carbs too much could result in blood sugar levels dipping dangerously low if youre also taking medication to decrease blood sugar, Escobar says