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12 Adipose tissue expansion increases leptin levels, which regulate appetite, energy expenditure, and glucose and lipid metabolism via hypothalamic signaling

Begin hydrating heavily 12 days before your first injection, maintain consistent small meals, avoid alcohol, and review any blood pressure medications with your provider

Janumet Side Effects and Black Box Warning Because Janumet is a combination medication, it has the side effect risks of Januvia plus metformin

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Seek immediate medical attention for severe or persistent abdominal pain (with or without vomiting), which could indicate pancreatitis

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