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DPP4i have no intrinsic glucose-lowering activity, so their efficacy as anti-diabetic agents is related directly to their ability to inhibit DPP4 activity and is mediated through the effects of the substrates they protect

This makes it different from semaglutide (which mimics GLP-1) and tirzepatide (which mimics GLP-1 and GIP)

Tonneijck, L., Muskiet, M

If thats the case, Fishman says you could talk to your healthcare provider about taking just the phentermine without the topiramate, which will help with the brain fog

GLP-1 receptor agonist exerts its action through the GLP-1R