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2 Although strategies such as refined diagnostic criteria can improve case detection, large-scale database studies cannot match the diagnostic precision achieved through manual chart review, which remains the most reliable method for confirming NAION cases, the commentary authors wrote

That places it squarely in the compounded category, where the FDA states that compounded drugs are not FDA-approved and that the agency does not verify their safety, effectiveness or quality before they are marketed

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This is because other options are available, such as metformin, that dont usually increase the frequency or severity of hypoglycemia (low blood sugar)