DPP4 and intestinal obstruction: Since insulin therapy often indicates more advanced disease progression, greater severity, or additional comorbidities, which may lead to a higher risk of intestinal obstruction, and there was no statistically significant difference in intestinal obstruction risk between GLP-1RAs and other anti-diabetic medications (e.g., SGLT2 inhibitors, metformin, sulfonylureas, thiazolidinediones, DPP-4 inhibitors), the observed reduction relative to insulin does not necessarily suggest a protective effect of GLP-1RAs against intestinal obstruction.