Starting at a lower initial dose (for example, 2 mg instead of 4 mg) also helped partially reduce these GI symptoms, andas with other GLP-1 medicationsthe dose was gradually increased over time to improve tolerability
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Additionally, participants achieved superior glycemic control compared with insulin degludec
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Hyperinsulinemia further exacerbates this endocrine imbalance by directly stimulating ovarian theca cells, increasing androgen production, and promoting the hormonal milieu characteristic of PCOS, a leading cause of anovulatory infertility [173, 174]