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Effects on birth weight percentiles were modest, with no increase in risk of large or small for gestational age and no difference in cesarean delivery rates.

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Strengths Acts via multiple pathways (GLP-1, AMPK, microbiome) Has existing human data showing reductions in fasting glucose, HbA1c, lipids Support receptor expression and islet health Limitations Low absorption and bioavailability Gastrointestinal discomfort is common (diarrhea, cramping)

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