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Stress triggers the release of cortisol, which in turn reduces the production of GLP-1

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The similar viewpoints were also supported by other critical reviews and clinical trials (58), and inferred that GLP-1RA could be considered in patients at a high risk of, or with established cardiovascular diseases to improve the prognosis of cardiovascular events (especially nonfatal stroke), whilst SGLT2i could be recommended for patients with heart failure or chronic kidney diseases

This stipulates that insurers require documented evidence of a medical necessity before authorizing coverage