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The New England Journal of Medicine, 384 (11), 9891002
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Figure 4 Flavonoids, which include flavanols, flavonols, flavones, flavanones, isoflavones, and anthocyanins, also possess DPP-4 inhibitory activityfor instance, the flavonoid-rich fraction of Pilea microphylla displayed antidiabetic efficacy in rats with diabetes generated by a high-fat diet and streptozotocin by lowering DPP-IV
Clinicians should be alert to this possibility when evaluating patients presenting with unexplained hypoglycemia who report GLP-1 agonist use, especially if obtained from non-pharmacy sources or online
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