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Foods to minimize or avoid include: Carbonated beverages, which introduce additional gas High-fiber foods initially (beans, cruciferous vegetables, whole grains), though fiber remains important long-term Artificial sweeteners, particularly sugar alcohols (sorbitol, xylitol), which can ferment in the gut Dairy products if lactose intolerance is present or suspected Fried or greasy foods that slow digestion Hydration remains essential, but patients should sip water throughout the day rather than consuming large volumes with meals, which can increase stomach distension

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For heart failure or chronic kidney disease, the American Diabetes Association generally recommends SGLT2 inhibitors as first-line agents, with GLP-1 receptor agonists considered for their benefits on atherosclerotic cardiovascular disease, glycemic control, and weight management, or when SGLT2 inhibitors are not appropriate

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