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For health insurers and group benefits sponsors, that scale of demand is turning GLP-1s from a niche therapy into a major driver of claims, plan design and risk

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The acronym SAD MANS is a useful mnemonic to remember medications that may have reduced clearance and an increased risk of adverse effects in people with CKD (Box)

These include action potential production in excitatory tissues used for cell adhesion and interactions, neurotransmitter utilisation in cell signalling such as dopamine, choline and GABA and the calcium uptake and retention regulation by synaptosomes