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For the newer GLP-1 medications, it would be useful to look at whether there are genetic variants, like the variants in PAM, that explain poor responders to their medications. For now, the mechanism driving GLP-1 resistance remains unresolved, but it is likely complex and multifactorial, Gloyn said

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It also does not prevent muscle loss or replace the need for hormonal stabilization when systemic deficits are present

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Long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study