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Another study on hemodialysis patients, over 50% of whom had T2DM, assessed the anti-IL-1 agent anakinra [211]

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However, those with pre-existing kidney disease, multiple risk factors, or experiencing significant gastrointestinal side effects should undergo more frequent assessment as clinically indicated

Prokinetic agents like metoclopramide present a theoretical option but should be used cautiously given potential adverse effects (including tardive dyskinesia with use beyond 12 weeks) and the counterintuitive nature of accelerating gastric emptying while using a medication that intentionally slows it

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Neither pathway guarantees superiority in clinical outcomes