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Mice with genetic gamma-glutamyl transpeptidase deficiency exhibit glutathionuria, severe growth failure, reduced life spans, and infertility

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Proc Natl Acad Sci USA 111:82938298 Bashir K, Nagasaka S, Itai RN, Kobayashi T, Takahashi M, Nakanishi H, Mori S, Nishizawa NK (2007) Expression and enzyme activity of glutathione reductase is upregulated by Fe-deficiency in graminaceous plants

Similarly, semaglutide increased natriuresis in Glp1r VSM+/+ mice, as shown by higher urine sodium and chloride concentrations (normalized to urine creatinine levels)actions attenuated, but not completely eliminated, in Glp1r VSM/ mice (Figure 4, B and C)

Most diabetes specialists would consider alternative combinationssuch as adding an SGLT2 inhibitor or adjusting insulin therapybefore prescribing both Rybelsus and Januvia together