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The FDA provides specific guidelines based on estimated glomerular filtration rate (eGFR): Strictly prohibited for patients with eGFR below 30 mL/minute/1.73 m Not recommended for starting treatment in patients with eGFR between 30-45 mL/minute/1.73 m Requires careful monitoring when eGFR falls below 45 mL/minute/1.73 m Patients should avoid metformin if they have: Diabetic ketoacidosis Severe liver problems Acute or chronic metabolic acidosis History of lactic acidosis Conditions causing tissue hypoxia The medication is not recommended for patients 80 and older without normal kidney function [22]

Kil IS, Park JW

Maternal obesity increases the risk and severity of NAFLD in offspring

Advantages and Disadvantages of GLP-1 While GLP-1 medications offer a breakthrough in treating obesity and metabolic dysfunction, they are not without trade-offs

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