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SGLT-2 lowers blood sugar levels by allowing more glucose to be expelled in urine

[7] [17] However, even without frank hypoglycemia, changes in glucose patterns during adaptation to therapy might contribute to fatigue in some individuals

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In a mouse model of RIRI, SeNP pretreatment reduced serum creatinine and blood urea nitrogen levels, alleviated tubular necrosis and inflammatory infiltration, and inhibited the elevation of ferroptosis marker ACSL4 and the decrease of GPX4, ultimately improving renal dysfunction and renal tissue structural damage [91]

Here's why: your skin cells turn over about every 28 days, and collagen production takes time to ramp up