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4 The second A1C tier between 7.6% and 9.0% lists the use of a GLP-1 analogue or metformin as initial treatment or later as a component of triple therapy

Investigations suggest that growth hormone-associated pathways may intersect with mitochondrial regulatory proteins involved in energy sensing and cellular resilience

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It would also help explain a clinical observation discussed later: the gastrointestinal side effects associated with amylin analogs (nausea, early fullness) tend to be most pronounced during dose escalation and to ease with continued treatment, a pattern consistent with partial adaptation of the very gastric mechanism in question