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[12] [13] However, individual patient responses vary, and any unexplained decline in renal function warrants thorough investigation
These include a relative or absolute increase in glucagon secretion from alpha cells of the pancreas, elevated serum free fatty-acid concentrations, an impaired incretin effect (e.g., decreased secretion of glucagon-like peptide-1 [GLP-1]), enhanced renal reabsorption of glucose, and dysregulation of appetite control via decreased neurotransmitter response in the brain
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