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The medication does not address underlying metabolic dysfunction or blood sugar regulation

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The metabolic (glucose-transport) arm of insulin signaling largely the PI3K/Akt pathway in muscle and fat is impaired, while the mitogenic and steroidogenic arms remain intact or even amplified

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Data availability The authors declare that all data supporting the findings of this study are available within the paper, Supplementary Information and the Source Data file

Patients should be advised to stay well hydrated, eat small frequent meals, and report severe or persistent gastrointestinal symptoms, as these may necessitate dose adjustment or additional management strategies