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Testing too early, even with twins, might result in a false negative simply because there isn't enough hCG in your urine or blood yet

352,435 Several mechanisms link metabolic disease with functional hypogonadism

The pathogenetic mechanism of most specific diabetes forms (except Maturity Onset Diabetes of the Young [MODY] 2, glucokinase mutations) is an insulin deficiency, which is treated in most instances with insulin first (except MODY 1 and 3, which are treated with sulfonylureas), and subsequently considering cardiorenal protective effects with SGLT-2 inhibitors and or GLP-1 receptor agonists (figure 1)

For GI discomfort questions, our stomach pains on reta article covers why abdominal symptoms show up in this class

Many patients with Hashimoto's successfully use these treatments