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It is essential to distinguish between pharmaceutical GLP-1 receptor agonistswhich are licensed medicines with robust clinical evidenceand probiotic supplements marketed with claims about GLP-1 modulation

These changes explain the range of gastrointestinal symptoms patients experience, from diarrhea to constipation

Nature 558 , 301306 (2018)

Hyperglycaemia differentially affects energy metabolism across kidney cell types, for example impeding glycolysis in glomerular epithelial cells (where glucose is the preferred energy substrate) while enhancing glycolysis in proximal tubular epithelial cells (which typically rely on fatty acid oxidation) [11]

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