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Shah P, Ardestani A, Dharmadhikari G, Laue S, Schumann DM, Kerr-Conte J, et al

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Nonetheless, the underlying reasons for the inconsistencies in the reported associations between T2DM and levels of plasma DPP-4 activity (lower, unaltered, higher) have not been adequately explained, although one study did suggest that it might be related to the populations studied, with changes only becoming evident once moderate or severe hyperglycaemia becomes established (68)

Growing evidence from observational studies indicates that treatment of obesity with bariatric surgery improves cardiovascular outcomes, but these findings have not been confirmed in randomized trials, largely because of randomization challenges with bariatric surgery