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Gastroenterology 151:165179 Shirakawa J, Okuyama T, Kyohara M et al (2016) DPP-4 inhibition improves early mortality, cell function, and adipose tissue inflammation in db/db mice fed a diet containing sucrose and linoleic acid

Clinicians provide real-time supervision

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So the safest approach is going to use the FDA-approved medications in the presence of someone that specializes in these types of medications