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this is the most important contraindication Severe uncontrolled diabetes , GH antagonizes insulin and can worsen glycemic control Active proliferative diabetic retinopathy Pregnancy or breastfeeding Pituitary disorders or recent pituitary surgery Anyone considering tesamorelin should have a baseline workup that includes IGF-1, fasting glucose, HbA1c, a lipid panel, and a careful medical history, not just to establish baselines for monitoring, but to confirm tesamorelin is mechanistically the right tool before starting

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