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22 However, the fact that the magnitude and speed of hemoglobin A1c reduction with treatment were identified as risk factors for progression suggests it could be another example of the well-established early worsening phenomenon first observed in type 1 diabetic patients intensively treated with insulin in the Oslo Study, Kroc Collaborative Study and Diabetes Control and Complications Trial

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5-7 Multiple studies have linked gut dysbiosis a change or imbalance in the diversity, composition and functions of the microbiota to reduced GLP-1 levels

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