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A retrospective study conducted at the University Health Network found that, in liver transplant recipients with diabetes, combination therapy reduced HbA1c and alanine aminotransferase levels more effectively than DPP-4 inhibitors. Additionally, two clinical trials in patients with Type 2 diabetes demonstrated that combination therapy significantly lowered HbA1c by 1.34% and 1.21%, compared to a 0.54% reduction with placebo, starting from a baseline of 8.0%. These findings suggest that combination therapy may be especially beneficial in the liver transplant population, where patients often experience weight gain and develop metabolic co-morbidities

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Randomized controlled trials indicate that intermittent fasting can lead to weight loss, but the sustainability of these results over time remains uncertain