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The mechanism is straightforward: GLP-1 RAs enhance glucose-dependent insulin secretion, and stacking that on top of glucose-independent insulin release from exogenous insulin or sulfonylureas removes the glucose-dependent safety brake

Adding phthalates to the mix made it worse

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The Board of Nursing has drawn a hard line, the Board of Pharmacy defers to narrow exceptions consistent with 503A, and FDA signals deference to prescriber judgment, but only if that judgment is well-documented