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[22] This is particularly important for patients taking oral semaglutide (Rybelsus) or medications with narrow therapeutic windows

Mouth sores, if they occur, may be multifactorial and warrant clinical assessment to exclude other causes such as viral infections, nutritional deficiencies (particularly vitamin B12, which can also be associated with metformin use in type 2 diabetes, folate, or iron), or autoimmune conditions

It is also possible that dual incretin agonists exert additional effects through modulation of GCG signaling