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1 CLINICAL STUDIES The safety and efficacy of dulaglutide were evaluated in six randomised, controlled, phase III trials involving 5,171 patients with type II diabetes

TNF- attenuates the insulin signalling pathway by inhibiting insulin receptor tyrosine kinase activity in adipocytes and decreasing tyrosine phosphorylation and IRS-1 activation, which in turn reduces the ability of cells to respond to insulin

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