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The mechanism underlying L-Carnitine's anti-obesity effects involves multiple pathways: facilitating long-chain fatty acid entry into mitochondria for oxidation, preventing accumulation of toxic lipid intermediates that impair insulin signaling, enhancing mitochondrial bioenergetics to support greater metabolic capacity, and modulating inflammatory pathways that contribute to metabolic dysfunction

Current guidelines do not recommend combination therapy with GLP-1 RAs and DPP-4 inhibitors, and the ADA/EASD consensus report specifically recommends discontinuation of DPP-4 inhibitors when initiating GLP-1 RA therapy

Though rare, serious side effects like breathing difficulties or allergic reactions can occur

Consequently, GLP-1RAs are currently recommended for treatment of T2D patients with higher risk of coronary heart diseases, owing to its anti-atherosclerosis and tube benefits

NCT04916470 and NCT04788511, respectively), are under investigation