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The way patients perceive changes in their treatment can have a significant impact on outcomes, as some may delay seeking medical advice or adjusting their treatment regimen without consulting a healthcare professional

Clinical studies have also indicated that metformin alone can increase GLP-1 levels, via a mechanism distinct from DPP-4 inhibition, and that combination therapy has a complementary effect on GLP-1 concentrations [27]

For example, some rare cancer trials may only be offered at an academic medical center like University of Iowa Health Care, where patients with those diagnoses are more commonly seen

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