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Pruritus characteristic of cirrhosis predominantly manifests as a central phenomenon, purportedly stemming from augmented release of -endorphin, Met-enkephalin, and endomorphin-1,2, which stimulate -receptors within nerve tissues

Patients typically report noticeable visceral fat reduction within 8-12 weeks, improved body composition metrics, enhanced recovery, better sleep quality, increased energy, and improved metabolic markers including fasting glucose and insulin sensitivity

Diabetic nephropathy amelioration by a low-dose sitagliptin in an animal model of type 2 diabetes (zucker diabetic fatty rat)

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Yes, switching is possible and common, but it must be done under physician supervision