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Fasting can then make it too easy to under-eat, skip fluids, or miss warning signs such as dizziness

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The final step in establishing preclinical proof-of-hypothesis was made when the results of these acute studies were recapitulated with chronic dosing, showing that the beneficial pancreatic islet and glucose-lowering effects of DPP-4 inhibition persisted over several months of treatment (30, 31)

The low risk of hypoglycaemia makes this combination particularly attractive compared to adding insulin or sulfonylureas

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