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10.1093/jexbot/53.372.1283 28 NoctorG.MhamdiA.ChaouchS.HanY

Indeed, after 48 weeks on dulaglutide, patients showed a markedly different community structure compared to baseline, with certain bacterial populations decreasing in relative abundance while others increased, indicating that sustained GLP-1 RA therapy can reshape the gut microbiota over time (38)

Novo Nordisk says, "Ozempic can be used as long as the product has not been exposed to temperatures below 36 F or above 86 F