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In comparison with basal insulin use, GLP-1RA use was associated with an adjusted HR of 0.91 (95% CI 0.73, 1.14) in the ITT analysis and 0.80 (95% CI 0.64, 1.01) in the per-protocol analysis

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Impurities can act as partial agonists, reduce receptor affinity, or introduce endotoxin-driven signaling that mimics or obscures IGF-1R biology

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