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After a single injection, mean plasma IGF-1 concentrations increased 1.5 to 3-fold for 9 to 11 days

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DPP-4 inhibitors were not included in the two tiers because their effectiveness on glycemic control is lower than or equivalent to first- and second-tier agents, as well as for less clinical evidence and relative expense

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(PubMed) Caldwell KL, Pan Y, Mortensen ME, Makhmudov A, Merrill L, Moye J