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This methodical progression serves multiple functions: Allows physiological adaptation to receptor stimulation Reduces treatment discontinuation from gastrointestinal adverse events Enables monitoring of metabolic markers at each dose level The gradual approach addresses common tolerability challenges associated with incretin-based medications, particularly nausea, vomiting, and diarrhea that can occur with rapid dose introduction

This could introduce some bias when determining whether the active drug or saline subcutaneous injection cause a local reaction

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