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In accordance with the down-regulation of adipogenic transcription factors, expression of insulin receptor, insulin receptor substrate-1 and glucose transporter 4 mRNA was decreased 3080% in WAT of HSL null mice compared with control [13]

However, keep in mind that if a medication is added as a third agent, it is typically less effective in lowering glucose than if it was used as a first- or second-line agent

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The fix is often straightforward, but only if the problem is recognized early