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Type 1 diabetics must monitor blood glucose multiple times daily and maintain close contact with their endocrinologist during any GLP-1 therapy

therefore, ethical approval was not required

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First, the weight loss itself reduces inflammatory burden, which may allow lower steroid doses to maintain disease control

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Weight loss during wateronly fasting is primarily driven by acute adaptive mechanisms, including sodium diuresis, lipolysis, and protein catabolism [25, 26]