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They look for any unexpected spikes in IGF-1 levels, which is the mediator of growth hormones actions, and monitor fasting glucose levels and oral glucose tolerance tests

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You can read the abstract of this article at In the SURPASS-4 trial, the dual GIP and GLP-1 receptor agonist tirzepatide demonstrated superior reductions in HbA1c concentrations, bodyweight, and blood pressure compared to titrated daily insulin glargine in individuals with type 2 diabetes and cardiovascular risk