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Beyond technical and evidentiary limitations, the absence of large-scale validation, cost-effectiveness analyses, and implementation dataparticularly in low-resource settings where pancreatogenic diabetes may be under-recognized yet prevalentrepresents a major barrier to near-term translation

Florenzano P, Jimenez M, Ferreira CR, Nesterova G, Roberts MS, Tella SH, Fernandez de Castro L, Gafni RI, Wolf M, Juppner H, Gales B, Wesseling-Perry K, Markovich D, Gahl WA, Salusky IB, Collins MT (2020) Nephropathic cystinosis: a distinct form of CKD-mineral and bone disorder that provides novel insights into the regulation of FGF23

doi:10.1097/AOG.0000000000002633

Intermittent fasting isn't automatically better on GLP-1s

Patient monitoring should include: Baseline lipid panel, hemoglobin A1c, and liver function tests Blood pressure monitoring (GLP-1 agents typically reduce systolic BP by 3-5 mmHg) [10] Assessment for gastrointestinal adverse effects during dose titration Evaluation for contraindications (personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2) [1] [3] Monitoring for gallbladder disease (increased risk with rapid weight loss) In patients with diabetes and retinopathy, monitoring for worsening eye symptoms, particularly with rapid glycemic improvement Renal function assessment, especially if severe gastrointestinal symptoms cause dehydration Patients should seek immediate medical attention for severe abdominal pain, which may indicate pancreatitisa rare but serious adverse effect