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In a 2-year trial with semaglutide injection involving patients with type 2 diabetes and high CV risk, more events of diabetic retinopathy complications occurred in patients treated with semaglutide injection (3%) compared to placebo (1.8%)

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suggested that the effect of DPP-4i in reducing NHE3 activity results from the inhibition of a tyrosine kinase signaling pathway rather than by activation of PKA (103)