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This is normal, not a sign the medication has stopped working

Willis AW, Roberts E, Beck JC, Fiske B, Ross W, Savica R, et al

Check Accessibility: Ask if the trial offers decentralized or at-home options

Practice Pearls: Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of oral drugs for type 2 diabetes that inhibit the breakdown of glucagon-like peptide-1 (GLP-1) and increase the release of insulin in response to a meal

Studies show DSIP modulates the hypothalamic-pituitary-adrenal axis, reducing cortisol and stress responses

Ethics declarations Ethical approval The study was approved by the Ethics Committee of Hospital de Clnicas de Porto Alegre (number 20180527)