To think about why that is, lets first consider an analogy
Major semaglutide weight loss trials (STEP 14) did not measure cortisol as a primary or secondary outcome
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Jung C, Park S, Kim H
The reported incidence of lactic acidosis in patients receiving metformin hydrochloride is very low (approximately 0.03 cases/1000 patient-years, with approximately 0.015 fatal cases/1000 patient-years)