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Diabet Med 29:e205e210 Vardarli I, Arndt E, Deacon CF, Holst JJ, Nauck MA (2014) Effects of sitagliptin and metformin treatment on incretin hormone and insulin secretory responses to oral and isoglycemic intravenous glucose

Metabolic alkalosis can result from persistent vomiting, which causes loss of gastric hydrochloric acid and hydrogen ions

Many patients experience mild heartburn during the first 2-4 weeks as their body adjusts to slower stomach emptying, then the symptom resolves naturally

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Some individuals report lingering mild nausea for 23 weeks, while others adapt within days